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Retrospective Study
Copyright ©The Author(s) 2025.
World J Gastrointest Surg. Dec 27, 2025; 17(12): 113940
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.113940
Table 1 Comparison of the baseline characteristics between the robotic liver resection and robotic intraoperative radiofrequency ablation groups before and after matching in de novo data, n (%)/median (interquartile range)
Variable
Before PS matching
After PS matching
RIO-RFA (n = 8)
R-LR (n = 49)
P value
RIO-RFA (n = 8)
R-LR (n = 8)
P value
Age (years)71.5 (68.5-74.2)68.0 (62.0-77.0)0.62171.5 (68.5-74.2)68.0 (58.8-77.5)0.713
Male5 (62.5)31 (63.3)15 (62.5)5 (62.5)1
Height (cm)164.5 (159.8-170.2)162.0 (157.0-168.0)0.4009164.5 (159.8-170.2)162.0 (156.5-166.5)0.4613
Weight (kg)66.5 (64.8-71.0)66.0 (53.0-75.0)0.542466.5 (64.8-71.0)60.0 (52.8-69.8)0.3998
BMI (kg/m2)24.5 (23.0-25.4)23.4 (20.8-26.9)0.611624.5 (23.0-25.4)23.0 (21.1-24.8)0.3823
HBV5 (62.5)33 (67.3)15 (62.5)6 (75.0)1
HCV3 (37.5)13 (26.5)0.67353 (37.5)2 (25.0)1
ICG-R15 < 10%1 (12.5)16 (32.7)0.41331 (12.5)2 (25.0)1
Platelet (103/mL)127.5 (97.2-156.5)169.0 (135.0-215.0)0.0179127.5 (97.2-156.5)135.5 (110.0-160.0)0.713
Prothrombin time (s)10.8 (10.7-11.1)10.6 (10.3-11.1)0.29510.8 (10.7-11.1)10.8 (10.4-11.0)0.5621
AST (U/L)106.5 (79.0-460.8)244.0 (82.0-511.0)0.5972106.5 (79.0-460.8)329.0 (174.0-857.5)0.1304
ALT (U/L)112.0 (75.2-444.5)307.0 (120.0-532.0)0.2802112.0 (75.2-444.5)366.5 (209.0-1018.8)0.1605
AFP ≥ 100 ng/mL2 (25.0)8 (16.3)0.61942 (25.0)1 (12.5)1
Bilirubin total (mg/dL)0.9 (0.8-1.1)0.8 (0.6-0.9)0.24780.9 (0.8-1.1)0.9 (0.8-1.0)1
Albumin (g/dL)4.2 (4.0-4.6)4.4 (4.1-4.7)0.55674.2 (4.0-4.6)4.6 (4.4-4.7)0.2448
ALBI (grade 1/2)6 (75.0)/2 (25.0)42 (85.7)/7 (14.3)0.5996 (75.0)/2 (25.0)7 (87.5)/1 (12.5)1
Child-Pugh
(class A/B)
7 (87.5)/1 (12.5)48 (98.0)/1 (2.0)0.26327 (87.5)/1 (12.5)8 (100.0)/0 (0.0)1
T stage (1/2/3/4)6 (75.0)/1 (12.5)/0 (0.0)/1 (12.5)36 (73.5)/12 (24.5)/1 (2.0)/0 (0.0)0.08126 (75.0)/1 (12.5)/1(12.5)5 (62.5)/3 (37.5)/0 (0.0)0.3515
Major tumor size (cm)1.6 (1.5-2.3)3.0 (1.8-4.5)0.03431.6 (1.5-2.3)2.1 (1.6-3.0)0.4589
Aggregate tumor size (cm)1.6 (1.6-2.8)3.1 (2.1-4.5)0.0711.6 (1.6-2.8)2.5 (1.9-3.0)0.5249
Tumor numbers
(1/2/3/4)
5 (62.5)/1 (12.5)/1 (12.5)/1 (12.5)39 (79.6)/10 (30.4)/0 (0)/0 (0)0.00535 (62.5)/1 (12.5)/1(12.5)/1 (12.5)7 (87.5)/1 (12.5)/0 (0)/0 (0)0.5062
Multi-tumors3 (37.5)10 (20.4)0.36533 (37.5)1 (12.5)0.5692
BCLC
(stage 0/A/B)
3 (37.5)/4 (50.0)/1 (12.5)9 (18.4)/31 (63.3)/9 (18.4)0.46583 (37.5)/4 (50.0)/1(12.5)2 (25.0)/6 (75.0)/0 (0.0)0.4493
Operation time (minutes)104.0 (68.8-128.8)175.0 (155.0-249.0)0.0002104.0 (68.8-128.8)114.5 (93.0-182.8)0.2698
SAS (score 2/3)5 (62.5)/3 (37.5)26 (53.1)/23 (46.9)0.71535 (62.5)/3 (37.5)4 (50.0)/4 (50.0)1
Blood loss (mL)10.0 (10.0-10.0)350.0 (105.0-805.0)0.000310.0 (10.0-10.0)80.0 (10.0-117.5)0.1179
Blood transfusion2 (25.0)31 (63.3)/18 (36.7)0.69932 (25.0)2 (25.0)1
Complication1 (12.5)11 (22.4)11 (12.5)2 (25.0)1
Hospital stays (days)9.5 (9.0-10.0)11.0 (9.0-14.0)0.36049.5 (9.0-10.0)10.5 (10.0-13.5)0.1151
Table 2 Comparison of the baseline characteristics between the robotic liver resection and robotic intraoperative radiofrequency ablation groups before and after matching in first recurrence data, n (%)/median (interquartile range)
Variable
Before PS matching
After PS matching
RIO-RFA (n = 8)
R-LR (n = 49)
P value
RIO-RFA (n = 8)
R-LR (n = 8)
P value
Age (years)71.5 (62.8-75.0)68.0 (63.0-75.5)0.860871.5 (62.8-75.0)67.0 (63.0-74.0)0.7769
Male14 (87.5)16 (80.0)0.672214 (87.5)13 (81.2)1
Height (cm)164.0 (157.2-170.5)166.5 (158.8-169.2)0.8984164.0 (157.2-170.5)167.5 (163.2-169.2)0.7196
Weight (kg)64.5 (54.5-78.5)65.5 (61.5-75.0)0.725864.5 (54.5-78.5)71.2 (63.8-75.2)0.4063
BMI (kg/m2)25.9 (20.7-27.0)26.2 (23.1-26.9)0.690625.9 (20.7-27.0)26.3 (24.5-27.0)0.534
HBV8 (50.0)14 (70.0)0.37938 (50.0)10 (62.5)0.7216
HCV4 (25.0)6 (30.0)14 (25.0)6 (37.5)0.7043
ICG-R15 < 10%5 (31.2)7 (35.0)15 (31.2)3 (18.8)0.6851
Platelet (103/mL)116.5 (89.5-151.5)123.0 (103.8-156.5)0.4737116.5 (89.5-151.5)117.5 (98.0-145.0)0.91
Prothrombin time (s)10.9 (10.5-11.0)10.5 (10.3-10.9)0.086710.9 (10.5-11.0)10.6 (10.4-10.9)0.2882
AST (U/L)323.0 (155.2-1067.2)194.0 (126.0-323.0)0.1345323.0 (155.2-1067.2)204.0 (126.8-323.0)0.2
ALT (U/L)266.5 (174.0-762.0)274.5 (130.0-437.5)0.4544266.5 (174.0-762.0)225.5 (130.0-384.2)0.3558
AFP ≥ 100 ng/mL4 (25.0)5 (25.0)14 (25.0)4 (25.0)1
Bilirubin total (mg/dL)1.0 (0.6-1.4)0.9 (0.7-1.1)0.39731.0 (0.6-1.4)0.9 (0.7-1.1)0.5962
Albumin (g/dL)4.5 (4.0-4.6)4.3 (4.0-4.7)0.77364.5 (4.0-4.6)4.5 (4.1-4.7)0.4602
ALBI (grade 1/2)12 (75.0)/4 (25.0)16 (80.0)/4 (20.0)112 (75.0)/4 (25.0)13 (81.2)/3 (18.8)1
Child-Pugh
(class A/B)
12 (75.0)/4 (25.0)18 (90.0)/2 (10.0)0.373812 (75.0)/4 (25.0)14 (87.5)/2 (12.5)0.6539
T stage (1/2/3/4)5 (31.2)/10 (62.5)/1 (6.2)13 (65.0)/6 (30.0)/1 (5.0)0.12485 (31.2)/10 (62.5)/1 (6.2)11 (68.8)/4 (25.0)/1 (6.2)0.0898
Major tumor size (cm)2.3 (1.7-2.7)1.9 (1.5-2.8)0.51332.3 (1.7-2.7)1.9 (1.3-2.2)0.2993
Aggregate tumor size (cm)3.3 (2.4-5.3)2.0 (1.8-3.4)0.05813.3 (2.4-5.3)1.9 (1.6-2.7)0.0184
Tumor numbers
(1/2/3/4/5)
7 (43.8)/4 (25.0)/3 (18.8)/1 (6.2)/1 (6.2)13 (65.0)/5 (25.0)/2 (10.0)/0 (0)/0 (0)0.44637 (43.8)/4 (25.0)/3 (18.8)/1 (6.2)/1 (6.2)11 (68.8)/3 (18.8)/2 (12.5)/0 (0)/0 (0)0.5198
Multi-tumors9 (56.2)7 (35.0)0.34859 (56.2)5 (31.2)0.285
BCLC (stage 0/A/B)1 (6.2)/12 (75.0)/3 (18.8)6 (30.0)/12 (60.0)/2 (10.0)0.18561 (6.2)/12 (75.0)/3 (18.8)6 (37.5)/9 (56.2)/1 (6.2)0.0821
Operation time (minutes)109.5 (100.0-175.5)167.5 (128.5-197.2)0.1043109.5 (100.0-175.5)164.5 (128.5-176.0)0.1998
SAS (score 2/3)9 (56.2)/7 (43.8)12 (60.0)/8 (40.0)19 (56.2)/7 (43.8)11 (68.8)/5 (31.2)0.715
Blood loss (mL)10.0 (10.0-55.0)175.0 (77.5-326.2)0.004610.0 (10.0-55.0)175.0 (10.0-266.2)0.0174
Blood transfusion5 (31.2)7 (35.0)15 (31.2)5 (31.2)1
Complication5 (31.2)2 (10.0)0.20365 (31.2)2 (12.5)0.3944
Hospital stays (days)8.0 (7.0-11.0)9.0 (7.8-12.0)0.38578.0 (7.0-11.0)9.0 (7.8-10.5)0.5055
Table 3 Univariate and multivariate analysis of prognostic factors for overall survival in de novo data
Variable
Before PS matching (n = 57)
After PS matching (n = 16)
Univariate
Multivariate
Univariate
Multivariate
HR (95%CI)
P value
HR (95%CI)
P value
HR (95%CI)
P value
HR (95%CI)
P value
Treatment0.61 (0.18-2.14)0.4430.58 (0.10-3.47)0.548
Age1.03 (0.98-1.08)0.1931.04 (0.99-1.10)0.1501.15 (0.97-1.37)0.1071.63 (0.74-3.56)0.224
Gender2.55 (1.00-6.49)0.0504.98 (1.03-24.06)0.0460.57 (0.06-5.12)0.613
HBV0.83 (0.32-2.15)0.7060.81 (0.13-4.89)0.818
HCV0.70 (0.23-2.13)0.5280.36 (0.04-3.27)0.363
ICG-R15 < 10%0.62 (0.20-1.89)0.4030.00 (0.00-inf)0.995
Platelet1.00 (0.99-1.00)0.4581.00 (0.98-1.02)0.988
Prothrombin time1.09 (0.74-1.59)0.6742.80 (0.69-11.37)0.1516.42 (0.17-249.92)0.319
AST1.00 (1.00-1.00)0.9731.00 (1.00-1.00)0.772
ALT1.00 (1.00-1.00)0.8691.00 (1.00-1.00)0.594
AFP ≥ 100 ng/mL1.15 (0.33-3.99)0.8230.00 (0.00-inf)0.996
Bilirubin total0.48 (0.09-2.71)0.4090.30 (0.00-22.14)0.584
Albumin0.55 (0.20-1.53)0.2520.12 (0.01-1.48)0.09831.48 (0.00-3.6 × 109)0.716
ALBI1.56 (0.51-4.73)0.4356.28 (0.86-45.89)0.0730.75 (0.00-8.2 × 106)0.591
Child-Pugh0.00 (0.00-inf)0.9960.00 (0.00-inf)0.996
T stage1.23 (0.62-2.42)0.5540.54 (0.09-3.09)0.489
Major tumor size1.18 (0.97-1.44)0.1061.40 (0.53-3.70)0.4971.64 (0.58-4.62)0.346
Aggregate tumor size1.16 (0.96-1.42)0.1320.95 (0.38-2.37)0.9051.28 (0.46-3.62)0.638
Tumor numbers0.88 (0.34-2.32)0.8000.00 (0.00-inf)0.996
BCLC1.59 (0.72-3.49)0.2490.71 (0.15-3.42)0.67
SAS0.95 (0.38-2.41)0.9172.26 (0.38-13.60)0.373
Complication1.07 (0.31-3.72)0.9116.28 (0.86-45.89)0.070.05 (0.00-2.7 × 1012)0.853
Table 4 Univariate and multivariate analysis of prognostic factors for recurrence-free survival in de novo data
Variable
Before PS matching (n = 36)
After PS matching (n = 32)
Univariate
Multivariate
Univariate
Multivariate
HR (95%CI)
P value
HR (95%CI)
P value
HR (95%CI)
P value
HR (95%CI)
P value
Treatment0.13 (0.02-0.66)0.0141.15 (0.01-264.01)0.9600.16 (0.03-0.83)0.0290.92 (0.00-299.08)0.977
Age1.00 (0.95-1.07)0.8861.01 (0.95-1.08)0.782
Gender0.54 (0.07-4.30)0.5560.54 (0.07-4.38)0.565
HBV1.26 (0.31-5.08)0.7421.62 (0.40-6.51)0.498
HCV0.67 (0.14-3.22)0.6140.53 (0.11-2.59)0.436
ICG-R15 < 10%1.82 (0.49-6.80)0.3733.35 (0.88-12.70)0.076100.80 (0.28-36753.83)0.125
Platelet1.00 (0.99-1.01)0.5141.00 (0.99-1.01)0.872
Prothrombin time1.60 (1.11-2.30)0.01116.45 (0.51-528.83)0.1141.55 (1.09-2.20)0.0153.06 (0.10-93.96)0.522
AST1.00 (1.00-1.00)0.1271.00 (0.99-1.01)0.9701.00 (1.00-1.00)0.1801.00 (0.99-1.01)0.643
ALT1.00 (1.00-1.00)0.9551.00 (1.00-1.00)0.882
AFP ≥ 100 ng/mL2.36 (0.63-8.84)0.2032.41 (0.64-9.01)0.1911.65 (0.07-36.92)0.753
Bilirubin total1.15 (0.24-5.58)0.8610.97 (0.19-5.03)0.970
Albumin0.41 (0.12-1.38)0.15026.60 (0.34-2088.41)0.1410.41 (0.13-1.25)0.1157.23 (0.07-799.58)0.410
ALBI1.18 (0.25-5.71)0.8341.31 (0.27-6.34)0.738
Child-Pugh2.08 (0.43-10.07)0.3621.77 (0.37-8.54)0.479
T stage3.79 (1.16-12.31)0.0270.09 (0.00-4.55)0.2253.87 (1.22-12.25)0.0210.31 (0.01-18.91)0.577
Major tumor size1.35 (0.83-2.20)0.2281.51 (0.93-2.43)0.0953.89 (0.07-211.13)0.505
Aggregate tumor size1.30 (1.05-1.61)0.0161.57 (0.70-3.56)0.2761.32 (1.08-1.61)0.0071.33 (0.38-4.66)0.652
Tumor numbers1.70 (0.99-2.91)0.0554.65 (0.77-27.97)0.0931.62 (0.95-2.76)0.07612.29 (0.28-534.39)0.192
BCLC2.87 (0.88-9.38)0.08226.75 (0.89-803.48)0.0583.70 (1.10-12.41)0.0340.99 (0.00-395.47)0.997
SAS0.80 (0.20-3.20)0.7491.00 (0.25-4.01)0.998
Complication7.29 (1.94-27.33)0.003142.17 (0.37-55319.72)0.1036.14 (1.64-23.03)0.0070.42 (0.00-83.99)0.750
Table 5 Univariate and multivariate analysis of prognostic factors for overall survival in first recurrence data
Variable
Before PS matching (n = 57)
After PS matching (n = 16)
Univariate
Multivariate
Univariate
Multivariate
HR (95%CI)
P value
HR (95%CI)
P value
HR (95%CI)
P value
HR (95%CI)
P value
Treatment1.34 (0.41-4.43)0.6311.45 (0.32-6.52)0.626
Age1.01 (0.98-1.05)0.4411.14 (1.00-1.29)0.0561.04 (0.81-1.32)0.769
Gender1.17 (0.55-2.47)0.6790.29 (0.03-2.40)0.249
HBV0.50 (0.24-1.04)0.0640.52 (0.24-1.11)0.0900.20 (0.04-0.95)0.0420.06 (0.00-1.45)0.084
HCV1.38 (0.63-3.03)0.4152.03 (0.45-9.18)0.356
ICG-R15 < 10%0.48 (0.20-1.18)0.1090.73 (0.27-1.99)0.5330.00 (0.00-inf)0.994
Platelet0.99 (0.99-1.00)0.0501.00 (0.99-1.00)0.5161.00 (0.99-1.01)0.7781.12 (0.08-15.00)0.930
Prothrombin time1.85 (1.06-3.23)0.0311.31 (0.77-2.25)0.3193.92 (0.97-15.91)0.056
AST1.00 (1.00-1.00)0.5261.00 (1.00-1.00)0.917
ALT1.00 (1.00-1.00)0.6391.00 (1.00-1.00)0.973
AFP ≥ 100 ng/mL0.69 (0.24-1.99)0.4930.00 (0.00-inf)0.994
Bilirubin total3.31 (0.74-14.89)0.1182.44 (0.42-14.28)0.3217.55 (0.24-234.20)0.249
Albumin0.47 (0.20-1.09)0.0790.65 (0.25-1.71)0.3830.44 (0.07-2.81)0.389
ALBI1.70 (0.69-4.18)0.2492.08 (0.40-10.81)0.383
Child-Pugh0.95 (0.13-7.01)0.9620.00 (0.00-inf)0.995
T stage0.96 (0.52-1.77)0.8990.74 (0.24-2.28)0.602
Major tumor size1.05 (0.89-1.25)0.5391.11 (0.49-2.54)0.802
Aggregate tumor size1.06 (0.90-1.25)0.4571.15 (0.50-2.66)0.747
Tumor numbers1.11 (0.60-2.04)0.7400.59 (0.14-2.56)0.479
BCLC1.09 (0.60-1.97)0.7860.51 (0.13-1.92)0.316
SAS1.73 (0.84-3.55)0.1371.25 (0.57-2.75)0.5744.70 (0.90-24.48)0.0660.94 (0.04-22.31)0.972
Complication0.67 (0.23-1.93)0.4592.08 (0.40-10.81)0.383
Table 6 Univariate and multivariate analysis of prognostic factors for recurrence-free survival in first recurrence data
Variable
Before PS matching (n = 36)
After PS matching (n = 32)
Univariate
Multivariate
Univariate
Multivariate
HR (95%CI)
P value
HR (95%CI)
P value
HR (95%CI)
P value
HR (95%CI)
P value
Treatment0.32 (0.13-0.81)0.0160.29 (0.09-0.97)0.0430.39 (0.15-1.00)0.0510.46 (0.13-1.61)0.226
Age0.99 (0.95-1.03)0.5861.00 (0.96-1.05)0.847
Gender2.77 (0.97-7.95)0.0586.60 (1.79-24.32)0.0043.22 (1.12-9.28)0.0306.81 (1.98-23.41)0.002
HBV0.61 (0.25-1.47)0.2670.74 (0.30-1.82)0.508
HCV1.04 (0.40-2.72)0.9370.88 (0.33-2.33)0.795
ICG-R15 < 10%1.22 (0.48-3.07)0.6752.42 (0.88-6.66)0.0881.33 (0.37-4.84)0.660
Platelet0.99 (0.99-1.00)0.1370.99 (0.98-1.00)0.1291.00 (0.99-1.00)0.321
Prothrombin time1.35 (0.95-1.92)0.0981.21 (0.88-1.66)0.2351.29 (0.90-1.87)0.1671.28 (0.91-1.80)0.153
AST1.00 (1.00-1.00)0.4181.00 (1.00-1.00)0.672
ALT1.00 (1.00-1.00)0.741.00 (1.00-1.00)0.782
AFP ≥ 100 ng/mL2.09 (0.82-5.32)0.122.60 (0.72-9.44)0.1452.69 (1.04-6.97)0.0412.08 (0.54-8.01)0.285
Bilirubin total1.72 (0.63-4.70)0.2931.26 (0.43-3.70)0.675
Albumin0.69 (0.24-1.98)0.4910.63 (0.23-1.73)0.369
ALBI1.44 (0.52-3.97)0.4821.28 (0.42-3.88)0.66
Child-Pugh1.32 (0.38-4.53)0.6581.15 (0.33-3.98)0.824
T stage1.36 (0.60-3.08)0.4551.34 (0.59-3.04)0.482
Major tumor size1.01 (0.67-1.53)0.9511.08 (0.68-1.71)0.743
Aggregate tumor size1.08 (0.89-1.32)0.4361.12 (0.93-1.35)0.214
Tumor numbers1.30 (0.85-1.98)0.2241.30 (0.87-1.95)0.202
BCLC1.08 (0.50-2.31)0.8431.41 (0.64-3.14)0.397
SAS0.74 (0.29-1.85)0.5141.02 (0.40-2.60)0.967
Complication4.20 (1.65-10.70)0.0033.62 (1.09-11.96)0.0343.78 (1.46-9.75)0.0063.08 (0.76-12.44)0.114
Table 7 Log-rank test results comparing overall survival between unstratified and risk-stratified subgroups of the robotic liver resection group in the de novo group prior to propensity score matching

Gender
Major tumor size
Aggregate tumor size
Low risk vs unstratified R-LR0.2080.0790.139
High risk vs unstratified R-LR0.0690.3700.281
Low risk vs unstratified RIO-RFA0.0680.0110.036
High risk vs unstratified RIO-RFA0.5950.8670.971
Table 8 Log-rank test results comparing overall survival between unstratified and risk-stratified subgroups of the robotic liver resection group in the first recurrence group after propensity score matching

Aggregate tumor size
Complication
Low risk vs unstratified R-LR0.3200.145
High risk vs unstratified R-LR< 0.001< 0.001
Low risk vs unstratified RIO-RFA0.1880.357
High risk vs unstratified RIO-RFA0.0570.122
Table 9 Log-rank test results comparing recurrence-free survival between unstratified and risk-stratified subgroups of the robotic liver resection group in the de novo group prior to propensity score matching

Platelet
Prothrombin time
Low risk vs unstratified R-LR0.1510.232
High risk vs unstratified R-LR0.0290.171
Low risk vs unstratified RIO-RFA0.7180.805
High risk vs unstratified RIO-RFA0.1060.240
Table 10 Log-rank test results comparing recurrence-free survival between unstratified and risk-stratified subgroups of the robotic intraoperative radiofrequency ablation group in the first recurrence group after propensity score matching

Platelet
OP time
Complication
Low risk vs unstratified R-LR0.9710.8440.343
High risk vs unstratified R-LR< 0.001< 0.001< 0.001
Low risk vs unstratified RIO-RFA0.1430.2160.428
High risk vs unstratified RIO-RFA0.0900.2300.159