{ "abstract": "Background: Elderly patients with hepatocellular carcinoma (HCC) are increasingly undergoing hepatectomy. Although laparoscopic liver resection (LLR) has been shown to provide better short‐term outcomes than open liver resection (OLR), long‐term outcomes are generally considered comparable. However, the impact of surgical approach on cause‐specific death, particularly non‐liver‐related death, remains unclear in elderly patients.\n\nMethods: This multicenter retrospective study included 969 patients ≥ 65 years old who underwent curative hepatectomy for solitary primary HCC ≤ 5 cm in maximum diameter at 18 institutions between 2010 and 2018. Propensity score matching was performed to reduce selection bias. Short‐ and long‐term outcomes, including liver‐related and non‐liver‐related death, were compared between LLR and OLR. Subgroup analyses were conducted according to age group.\n\nResults: After matching, LLR was significantly associated with lower blood loss, fewer postoperative complications, and shorter hospital stay than OLR. In the entire cohort, overall survival did not differ between groups. Among non‐liver‐related deaths, respiratory disease‐related death was more frequent in the OLR group. Among patients ≥ 80 years old, the incidence of non‐liver‐related death excluding death from other cancers was significantly lower in the LLR group, even after propensity score matching.\n\nConclusions: LLR may reduce the risk of non‐liver‐related death excluding death from other cancers in patients ≥ 80 years old with solitary HCC ≤ 5 cm in maximum diameter. When determining surgical strategies in elderly patients, it is important to consider long‐term systemic outcomes in addition to oncological factors. In patients for whom LLR is technically feasible, its minimally invasive nature may provide clinical benefits.", "abstract_shown": true, "affiliations": [ "Kyushu Study Group of Liver Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan", "Department of Gastroenterological, Breast and Endocrine Surgery Yamaguchi University Graduate School of Medicine Ube Japan", "Health Data Science Lab, Faculty of Data Science Shimonoseki City University Shimonoseki Japan", "Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery Kurume University Kurume Japan", "Department of Gastroenterological Surgery, Graduate School of Life Sciences Kumamoto University Kumamoto Japan", "Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan", "Department of Hepato‐Biliary‐Pancreatic Surgery, Clinical Research Institute National Hospital Organization Kyushu Medical Center Fukuoka Japan", "Department of Surgery Saga University Faculty of Medicine Saga Japan", "Department of Digestive Surgery Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan", "Department of Surgery Saga‐Ken Medical Centre Koseikan Saga Japan", "Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Graduate School of Medicine Yufu Japan", "Clinical Research Center and Department of Surgery National Hospital Organization Nagasaki Medical Center Ōmura Japan", "Division of Hepato‐Biliary‐Pancreas Surgery, Department of Surgery University of Miyazaki Faculty of Medicine Miyazaki Japan", "Department of Surgery Kagoshima Kouseiren Hospital Kagoshima Japan", "Department of Surgery Oita Prefectural Hospital Oita Japan", "Department of Surgery, Gastroenterology and Hepatology Center Kitakyushu City Yahata Hospital Kitakyushu Japan", "Department of Gastroenterological Surgery, Faculty of Medicine Fukuoka University Fukuoka Japan", "Department of Digestive and General Surgery, Graduate School of Medicine University of the Ryukyus Ginowan Japan", "Department of Surgery Yamaga City Medical Center Yamaga Japan", "Department of Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan" ], "article_type": "research article", "arxiv": null, "author_total": 20, "authors": [ { "affs": [ 0, 1 ], "name": "Yukio Tokumitsu", "orcid": "0000-0003-4916-4674" }, { "affs": [ 0, 1 ], "name": "Hidenori Takahashi" }, { "affs": [ 1, 2 ], "name": "Yuki Nakagami" }, { "affs": [ 0, 3 ], "name": "Toru Hisaka" }, { "affs": [ 0, 4 ], "name": "Hiromitsu Hayashi", "orcid": "0000-0002-1832-4287" }, { "affs": [ 0, 5 ], "name": "Tomoharu Yoshizumi" }, { "affs": [ 0, 6 ], "name": "Norifumi Harimoto" }, { "affs": [ 0, 7 ], "name": "Takao Ide" }, { "affs": [ 0, 8 ], "name": "Yoichi Yamasaki" }, { "affs": [ 0, 9 ], "name": "Atsushi Miyoshi" }, { "affs": [ 0, 10 ], "name": "Yuichi Endo", "orcid": "0000-0002-8792-4067" }, { "affs": [ 0, 11 ], "name": "Tamotsu Kuroki" }, { "affs": [ 0, 12 ], "name": "Atsushi Nanashima" }, { "affs": [ 0, 13 ], "name": "Masahiko Sakoda" }, { "affs": [ 0, 14 ], "name": "Tohru Utsunomiya" }, { "affs": [ 0, 15 ], "name": "Kohji Okamoto", "orcid": "0000-0002-9170-717X" }, { "affs": [ 0, 16 ], "name": "Masatoshi Kajiwara" }, { "affs": [ 0, 17 ], "name": "Mitsuhisa Takatsuki" }, { "affs": [ 0, 18 ], "name": "Toru Beppu", "orcid": "0000-0001-9046-0454" }, { "affs": [ 0, 19 ], "name": "Susumu Eguchi", "orcid": "0000-0002-7876-0152" } ], "bibtex": "https://research.draconitic.com/paper/ew5y21ts8f2ac.bib", "cited_by": 0, "doi": "10.1002/ags3.70306", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727762/?tool=EBI", "id": "ew5y21ts8f2ac", "issns": [ "2475-0328" ], "landing_url": "https://europepmc.org/article/PMC/PMC13727762", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Hepato‐Biliary‐Pancreatic" ], [ "heading", "ORIGINAL ARTICLE" ], [ "heading", "Original Article" ], [ "openalex", "2721|Hepatocellular Carcinoma Treatment and Prognosis" ] ], "openalex": "W7225155325", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727762/pdf/?tool=EBI", "pmcid": "PMC13727762", "pmid": "42978752", "published": "2026-11-02", "publisher": "Wiley", "ris": "https://research.draconitic.com/paper/ew5y21ts8f2ac.ris", "sources": [ { "first_seen": "2026-11-04T15:20:46Z", "native_id": "PMC:PMC13727762", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13727762" }, { "first_seen": "2026-11-06T12:23:35Z", "native_id": "PMC13727762", "source": "pmc", "url": "https://doi.org/10.1002/ags3.70306" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2721|Hepatocellular Carcinoma Treatment and Prognosis", "subfield": "general" } ], "title": "Impact of Laparoscopic Liver Resection on Long‐Term Outcomes and Non‐Liver‐Related Mortality in Elderly Patients With Primary Hepatocellular Carcinoma: A Multicenter Propensity Score‐Matched Analysis", "title_text": "Impact of Laparoscopic Liver Resection on Long‐Term Outcomes and Non‐Liver‐Related Mortality in Elderly Patients With Primary Hepatocellular Carcinoma: A Multicenter Propensity Score‐Matched Analysis", "type": "peer-reviewed", "updated_at": "2026-11-06T12:23:35Z", "url": "https://research.draconitic.com/paper/ew5y21ts8f2ac", "venue": "Annals of gastroenterological surgery", "versions": [] }