Outcomes of robotic liver resection and intraoperative radiofrequency ablation for hepatocellular carcinoma in posterior segments VII and VIII

Sep 28, 2026

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Hepatocellular carcinoma located in liver segments VII and VIII is technically demanding for both surgical resection and radiofrequency ablation (RFA). This retrospective study compares robotic liver resection (R-LR) with robotic intraoperative RFA (RIO-RFA) using propensity score matching to address selection bias. Among 93 patients treated between 2015 and 2024, overall survival and recurrence-free survival were similar for de novo cases, while recurrent disease showed better survival after R-LR. Tumor size, platelet count, and postoperative complications were key prognostic factors, supporting individualized treatment selection.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages19

Reading Time48 min

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Abstract

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Citation

| W | J | G | S | World Journal of
Gastrointestinal Surgery | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Surg 2025 December 27; 17(12): 113940 DOI: 10.4240/wjgs.v17.i12.113940 ISSN 1948-9366 (online) ORIGINAL ARTICLE Retrospective Study Outcomes of robotic liver resection and intraoperative radiofrequency ablation for hepatocellular carcinoma in posterior segments VII and VIII Cheng-Ming Peng, Shao-Chieh Lin, Yung-Yin Cheng, Teng-Chieh Cheng, Ching-Lung Hsieh, Chia-Hong Hsieh, Mei-Fang Hsieh, Chun-Han Liao, Ming-Cheng Liu, Yi-Jui Liu Specialty type: Gastroenterology and hepatology Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade A, Grade A Novelty: Grade A, Grade A Creativity or Innovation: Grade A, Grade A Scientific Significance: Grade A, Grade A P-Reviewer: Li JT, MD, Assistant Professor, China Received: September 8, 2025 Revised: September 24, 2025 Accepted: October 28, 2025 Published online: December 27, 2025 Processing time: 108 Days and 19.8 Hours Cheng-Ming Peng, Ching-Lung Hsieh, Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan Cheng-Ming Peng, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan Shao-Chieh Lin, Yung-Yin Cheng, Chia-Hong Hsieh, Mei-Fang Hsieh, Chun-Han Liao, Ph.D. Program of Electrical and Communications Engineering, Feng Chia University, Taichung 407, Taiwan Yung-Yin Cheng, Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung 402, Taiwan Teng-Chieh Cheng, Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung 40201, Taiwan Ching-Lung Hsieh, Department of Computer Science and Information Engineering, Feng Chia University, Taichung 40724, Taiwan Chia-Hong Hsieh, Department of Radiology, Taichung Armed Forces General Hospital, Taichung 411, Taiwan Mei-Fang Hsieh, Chun-Han Liao, Department of Medical Imaging, Changhua Christian Hospital, Changhua 500, Taiwan Chun-Han Liao, Division of Medical Imaging, Yuanlin Christian Hospital, Changhua 510, Taiwan Ming-Cheng Liu, Department of Medical Imaging, Taichung Veterans General Hospital, Taichung 407, Taiwan Yi-Jui Liu, Department of Automatic Control Engineering, Feng Chia University, Taichung 407, Taiwan Corresponding author: Yi-Jui Liu, PhD, Professor, Department of Automatic Control Engineering, Feng Chia University, No. 100 Wenhwa Road, Seatwen, Taichung 407, Taiwan. WJGS [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 27, 2025 Volume 17 Issue 12 Peng MC et al. Resection or ablation for challenging HCC [erliu@fcu.edu.tw](erliu@fcu.edu.tw) Abstract BACKGROUND Hepatocellular carcinoma (HCC) in segments VII and VIII poses technical challenges for both liver resection and radiofrequency ablation (RFA) . Robotic-assisted techniques may enhance safety and precision, but comparative evidence remains limited. AIM To compare the clinical outcomes of robotic liver resection (R-LR) and robotic intraoperative RFA (RIO-RFA) for HCC located in liver segments VII and VIII. METHODS We retrospectively analyzed 93 HCC patients in segments VII/VIII with de novo (n = 57) or first recurrent (n = 36) . HCC who underwent R-LR or RIO-RFA between 2015 and 2024. Propensity score matching was performed to reduce selection bias. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS) . KaplanMeier curves, log-rank tests, and Cox regression were used to identify prognostic factors for OS and RFS. RESULTS In the de novo group, OS and RFS did not differ significantly between R-LR and RIO-RFA before or after propensity score matching. In contrast, the recurrent group showed significantly improved OS and RFS with R-LR (P = 0.005 and P =

FAQs

What clinical comparison does the study evaluate?

It compares clinical outcomes of robotic liver resection (R-LR) versus robotic intraoperative RFA (RIO-RFA) for hepatocellular carcinoma in posterior segments VII and VIII.

How did the outcomes differ between de novo and first recurrent HCC?

For de novo HCC, overall survival and recurrence-free survival did not differ significantly between R-LR and RIO-RFA. For recurrent HCC, R-LR showed significantly improved overall and recurrence-free survival.

What factors were identified as key prognostic indicators?

Tumor size, platelet count, and postoperative complications were reported as key prognostic factors influencing survival and recurrence outcomes.

Sep 28, 2026

Uploaded by McQueen