Evaluation of hepatic resection for hepatocellular carcinoma in the elderly

The results of 139 hepatic resections in 154 patients with hepatocellular carcinoma (HCC) operated upon in the last 6 years are reported. These 139 Japanese patients were classified into three groups according to age. Group I included 58 patients under 55 years of age, group II 44 aged from 56 to 65 years and group III 37 aged over 66 years. Fewer cases in group III had histological evidence of cirrhosis than in the other two groups. There was a statistically significant marked decline in the preoperative cardiac and pulmonary function in group III patients. However, there was no statistical difference in postoperative complications, mortality and survival rate among the three groups. The results after hepatic resection seemed to depend on pre-operative liver function and histology, and on control of the haemorrhage at operation. The results indicate that liver surgery for elderly patients with hepatocellular carcinoma is justifiable given careful patient selection.