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Effect of Age (over 75 Years) on Postoperative Complications and Survival in Patients Undergoing Hepatic Resection for Hepatocellular Carcinoma

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Thanks to technical advancement in surgery for hepatocellular carcinoma (HCC), hepatic resection (HR) for elderly HCC patients has become safer. However, elderly patients may have shorter long-term survival after surgery if compared with younger patients because of their expected life span. The aim of the present study was to evaluate clinical outcomes and safety after HR in HCC patients aged >75 years (older) compared with HCC patients aged <75 years (younger).

Method

One hundred sixty-eight patients who underwent HR for HCC from 1998 to 2015 in our Center were analyzed using a prospective database. Complications, disease-free survival rates, and cumulative survival rates were compared between the two groups.

Results

During the immediate postoperative period, no differences were found about liver-related complications, hospital stay and 90-day mortality. However, older patients had more complications in class II or higher (Clavien classification) (p = 0.017). Although disease-free survival in both groups was similar (p = 0.099), overall survival was worse in the elderly group (p = 0.024). On multivariate analysis, only age ≥75 years was significantly related to overall survival.

Conclusion

If elderly patients with liver cirrhosis and HCC are appropriately selected and evaluated, they might have favorable prognoses after HR.

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Authors and Affiliations

  1. UOC di Chirurgia Epato-bilio-pancreatica e Digestiva, Ospedale San Paolo, Università di Milano, via A. di Rudini’ 8, 20142, Milan, Italy

    Roberto Santambrogio, Matteo Barabino, Giovanna Scifo, Mara Costa, Marco Giovenzana & Enrico Opocher

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  1. Roberto Santambrogio
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  2. Matteo Barabino
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  3. Giovanna Scifo
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  4. Mara Costa
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  5. Marco Giovenzana
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  6. Enrico Opocher
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Correspondence to Roberto Santambrogio.

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Conflict of Interest

Roberto Santambrogio, Matteo Barabino, Giovanna Scifo, Mara Costa, Marco Giovenzana, and Enrico Opocher have no conflicts of interest or financial ties to disclose and all authors must meet all of the criteria according the guidelines of the International Committee of Medical Journal Editors (ICMJE).

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Santambrogio, R., Barabino, M., Scifo, G. et al. Effect of Age (over 75 Years) on Postoperative Complications and Survival in Patients Undergoing Hepatic Resection for Hepatocellular Carcinoma. J Gastrointest Surg 21, 657–665 (2017). https://doi.org/10.1007/s11605-016-3354-1

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  • DOI: https://doi.org/10.1007/s11605-016-3354-1

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