Overview
This multicenter, ambispective cohort study evaluates the safety and efficacy of trans-arterial Indocyanine Green (ICG) fluorescence-guided laparoscopic liver watershed resection for Hepatocellular Carcinoma (HCC). The study aims to compare the outcomes of the trans-arterial ICG staining approach versus the conventional trans-portal (portal vein) ICG staining approach.
Description
The study employs an ambispective design, comprising:
A Retrospective Cohort: Collecting clinical data from patients treated between June 2020 and August 2025.
A Prospective Cohort: Enrolling new patients from January 2026 to January 2027. Data will be collected from three medical centers. The primary objective is to compare the oncological prognosis, specifically Recurrence-Free Survival (RFS), between the two navigation methods. Secondary objectives include perioperative safety, liver function recovery, and Overall Survival (OS).
Eligibility
Inclusion Criteria:
- Age 18-80 years.
- Postoperative histopathological diagnosis of Hepatocellular Carcinoma (HCC).
- Underwent ICG fluorescence-guided laparoscopic anatomical liver resection.
- Child-Pugh Class A or B.
- ASA score I-III.
- ECOG Performance Status 0-2.
- No invasion of major vessels (main portal vein/first-order branches, main hepatic vein).
- No distant metastasis.
Exclusion Criteria:
- Pathology confirms non-HCC components (e.g., cholangiocarcinoma, combined HCC-ICC) or metastatic liver cancer.
- Concomitant other active malignancies.
- Preoperative anti-tumor therapy (TACE, ablation, radiotherapy, systemic therapy) or history of prior hepatectomy.
- Ruptured tumor.
- Conversion to open surgery.
- Unclear surgical records regarding ICG staining method.
- Intraoperative ICG staining failure (e.g., diffuse staining, unclear boundaries) preventing fluorescence-guided resection.
- Missing data preventing primary endpoint assessment.