Hepatectomy is a reasonable option for older patients with hepatocellular carcinoma

Abstract Background Hepatic resection is the main treatment for patients with hepatocellular carcinoma. However, surgery is generally stressful for older patients. Methods Clinicopathologic data and outcomes after hepatic resection were retrospectively investigated for older patients with hepatocell...

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Published in:The American journal of surgery 2015-02, Vol.209 (2), p.391-397
Main Authors: Kim, Jong Man, M.D., Ph.D, Cho, Bong Ick, M.D, Kwon, Choon Hyuck David, M.D., Ph.D, Joh, Jae-Won, M.D., Ph.D, Park, Jae Berm, M.D., Ph.D, Lee, Joon Hyeok, M.D., Ph.D, Kim, Sung Joo, M.D., Ph.D, Paik, Seung Woon, M.D., Ph.D, Park, Cheol Keun, M.D., Ph.D
Format: Article
Language:English
Subjects:
Age
Age Factors
Aged
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Comorbidity
Confidence intervals
Disease-Free Survival
Female
Hepatic resection
Hepatitis B virus
Hepatocellular carcinoma
Humans
Liver cancer
Liver cirrhosis
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Male
Medical treatment
Metastasis
Middle Aged
Mortality
Older
Phosphatase
Pneumonia
Pneumonia - epidemiology
Postoperative Complications - epidemiology
Postoperative mortality
Proteins
Retention
Retrospective Studies
Surgery
Survival analysis
Tomography
Treatment Outcome
Tumors
Veins & arteries
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Summary:Abstract Background Hepatic resection is the main treatment for patients with hepatocellular carcinoma. However, surgery is generally stressful for older patients. Methods Clinicopathologic data and outcomes after hepatic resection were retrospectively investigated for older patients with hepatocellular carcinoma. The younger group (n = 219) included patients aged 60 to 69 years, and the older group (n = 60) included patients >70 years of age. Results Hepatitis B virus was more common in the younger group than in the older group (64.5% vs 28.8%, P < .001). The occurrence of pneumonia was higher in older group than in the younger group (10.0% vs 2.3%, P = .015), but postoperative complications and mortality were not significantly different between the 2 groups. There was no statistically significant difference in disease-free survival rates between the 2 groups. Conclusions Although the incidence of postoperative pneumonia was higher in the older group than in the younger group, hepatic resection was justified for hepatocellular carcinoma in selected patients >70 years of age.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2013.06.010