Prognosis of patients with hepatocellular carcinoma after hepatic resection: Are elderly patients suitable for surgery?
Version of Record online: 1 APR 2011
Copyright © 2011 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 104, Issue 3, pages 284–291, 1 September 2011
How to Cite
Nanashima, A., Abo, T., Nonaka, T., Fukuoka, H., Hidaka, S., Takeshita, H., Ichikawa, T., Sawai, T., Yasutake, T., Nakao, K. and Nagayasu, T. (2011), Prognosis of patients with hepatocellular carcinoma after hepatic resection: Are elderly patients suitable for surgery?. J. Surg. Oncol., 104: 284–291. doi: 10.1002/jso.21932
- Issue online: 1 AUG 2011
- Version of Record online: 1 APR 2011
- Manuscript Accepted: 14 MAR 2011
- Manuscript Received: 9 SEP 2010
- hepatocellular carcinoma;
- elderly patients;
The indication for hepatectomy is still controversial in elderly patients with hepatocellular carcinoma (HCC). We examined the clinicopathological features and survival of 188 HCC patients who underwent hepatectomy.
Patients were divided into four age groups: Age<50 group (young patients <50 years of age, n = 9), Age50–69 group (between 50–69 years, n = 110), Age70–79 group (70–79 years, n = 57), and Age≥80 group (≥80 years, n = 12). Physiologic ability and surgical stress (E-PASS) score, including preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS) were assessed.
Proportion of patients of Age70–79 and Age≥80 groups increased significantly in the last 5 years (P < 0.01). Co-morbidity, performance status, and American Society of Anesthesiologists score significantly increased with age (P < 0.05). Proportions of patients with irregular findings and necro-inflammatory activity were significantly lower in Age70–79 and Age≥80 groups than in other groups (P < 0.05). Systemic postoperative complications were high in Age70–79 and Age≥80 groups. PRS increased significantly with age (P < 0.05). Multivariate analysis identified PRS ≥0.32 and age ≥70 years as significant determinants of systemic complications (P < 0.05). There were no significant differences in postoperative survivals among the groups.
Careful follow-up and proper decision on hepatectomy upon assessment of PRS are important in elderly HCC patients. J. Surg. Oncol. 2011; 104:284–291. © 2011 Wiley-Liss, Inc.