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Hepatic resection for hepatocellular carcinoma in elderly patients
Chun-Nan Yeh1, Wei-Chen Lee, Long-Bin Jeng
1Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipai, Taiwan. ycn@adm.cgmh.org.tw
Background/Aims:
We present the clinical features and outcome of 34 patients with hepatocellular carcinoma older than 70 years of age who underwent hepatic resection (elderly-HCC). Nowadays, hepatic surgeons unavoidably have to perform hepatic resection on elderly patients with hepatocellular carcinoma due to increasing life expectancy. However, the outcome of hepatic resection on elderly patients with hepatocellular carcinoma varies in each series, and the exact role of surgery in the management of hepatocellular carcinoma in the elderly remains to be clarified.
Methodology:
From 1986 to 1998, the clinical features of 34 surgically treated cases of elderly-HCC were reviewed. Factors that may influence the outcome were also analyzed. Clinical features and outcome of 398 patients with hepatocellular carcinoma younger than 70 years old (younger-HCC) were also summarized for comparison.
Results:
Of 432 surgically resected hepatocellular carcinomas, 34 (7.9%) were elderly-HCC. More underlying diabetes mellitus association, higher hepatitis C infection, and lower hepatitis B infection were observed in the elderly-HCC group. More blood loss, larger tumor size, less capsule formation, and more recurrence were significantly prominent in the patients in the younger-HCC group compared with the elderly-HCC group. The patients in the elderly-HCC group had a favorable disease-free survival rate compared with the younger-HCC group, although not statistically significant. The 1- and 5-year survival rates of elderly-HCC patients were 85.3% and 39.6%, respectively. No significant difference in survival or mortality rate was found between elderly-HCC and younger-HCC groups.
Conclusions:
We present the clinical features and outcomes of 34 elderly patients with hepatocellular carcinoma who underwent hepatic resection. The results seem to indicate that hepatic resection is safe and feasible in the elderly with hepatocellular carcinoma with or without cirrhosis. The prognosis after hepatic resection is as comparable as that of the younger patients with hepatocellular carcinoma.