Ann Surg Treat Res.  2020 Aug;99(2):65-71. 10.4174/astr.2020.99.2.65.

Hepatocellular carcinoma in old age: are there any benefits of liver resection in old age?

• Shin IS
• Kim DG
• Cha SW
• Kang SH
• Kim SH
• Kim MY
• Baik SK

• KMID: 2504818
• DOI: http://doi.org/10.4174/astr.2020.99.2.65

Abstract

Purpose
Elderly individuals have comorbidities that can adversely affect surgical outcomes. Some studies reported that elderly patients with hepatocellular carcinoma (HCC) have higher liver- and non-liver–related deaths. Therefore, palliative treatments are preferred in these patients. We compared surgical treatment outcomes between young and old age groups.
Methods
In total, 233 liver resections were performed in patients with HCC from March 2012 to December 2018. We retrospectively reviewed medical records. The old age group was defined as patients aged more than 70 years. We compared perioperative characteristics and surgical outcomes and analyzed the prognostic factors for disease-free survival (DFS) and overall survival (OS) rates.
Results
The young and old age group included 184 and 49 patients, respectively. Preoperative characteristics were similar. Major liver resection rate was similar (young age group, 26.1% vs. old age group, 20.4%), but the operation time was a little bit shorter in old age group. Major postoperative complications were 23 (12.5%) and 9 (18.4%) in the young and old age group (P = 0.351). Median non-liver–related overall survival were 80 and 76 months (P = 0.889) and liver-related OS were 76 and 76 months (P = 0.514) in the young and old age groups, respectively. Age was not an independent risk factor for DFS and OS.
Conclusion
Elderly patients showed similar non-liver- and liver-related OS rates as young patients after liver resection. Postoperative complications were also similar. If elderly patients are well selected, they can receive curative treatment and show good surgical outcomes.

Keyword

Hepatocellular carcinoma; Non-liver–related overall survival; Old age; Young age

Figure

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  Fig. 1 Overall survival rates in the young and old age groups according to the cause of death. (A) Liver-related overall survival between both groups (P = 0.514). (B) Non-liver–related overall survival between both groups (P = 0.889). (C) Overall survival by liver-related, non-liver–related, and operative mortality between both groups (P = 0.849) did not show a significant difference.

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