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Surgical Outcomes and Clinical Characteristics of Elderly Patients Undergoing Curative Hepatectomy for Hepatocellular Carcinoma

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The aim of this study was to investigate the clinical characteristics and outcomes of elderly patients (≥70 years old) undergoing curative hepatectomy for hepatocellular carcinoma (HCC).

Methods

Clinicopathological data and treatment outcomes in 100 elderly patients (≥70 years old) and 120 control patients (≤70 years old) with HCC who underwent curative hepatectomy between 2000 and 2011 were retrospectively collected and compared.

Results

The overall survival rate was similar between the two groups, but the disease-free survival rate was worse in the elderly group when compared with the control group. Prognostic factors for overall and disease-free survival were the same when comparing the two groups. The elderly group had higher rate of females (p = 0.0230), higher hepatitis C virus infection rate (p = 0.0090), higher postoperative pulmonary complication rate (p = 0.0484), lower rate of response to interferon (IFN) therapy (p = 0.0203) and shorter surgical time (p = 0.0337) when compared with the control group. The overall recurrence rate was higher in the elderly group than in the control group (p = 0.0346), but the rate of recurrence within 2 years after the operation was similar when comparing the two groups.

Conclusion

The survival of elderly patients with HCC was similar to that of younger patients. However, the disease-free survival was worse in elderly patients than in younger patients. Aggressive antiviral therapy (e.g. IFN therapy) may be necessary to improve the disease-free survival, even in elderly patients. Additionally, clinicians should be aware of the risk of pulmonary complications in elderly patients after hepatectomy.

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Abbreviations

AFP:

alpha-fetoprotein

ASA:

American Society of Anaesthesiologists

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

BMI:

Body mass index

CT:

Computed tomography

HA:

Hyaluronic acid

HCC:

Hepatocellular carcinoma

ICG:

Indocyanine green clearance

IFN:

Interferon

L3-AFP:

Lens culinaris agglutinin-reactive fraction of AFP

MRI:

Magnetic resonance imaging

MVI:

Microvascular invasion

PIVKA-II:

Protein-induced vitamin K absence-II

PT-INR:

Prothrombin time-international normal ratio

SM:

Surgical margin

TACE:

Transcatheter arterial chemoembolisation

TB:

Total bilirubin

US:

Ultrasonography

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Authors and Affiliations

  1. Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan

    Fumitoshi Hirokawa, Michihiro Hayashi, Yoshiharu Miyamoto, Mitsuhiro Asakuma, Tetsunosuke Shimizu, Koji Komeda, Yoshihiro Inoue & Kazuhisa Uchiyama

  2. Department of Pathology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan

    Atsushi Takeshita & Yuro Shibayama

Authors
  1. Fumitoshi Hirokawa
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  2. Michihiro Hayashi
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  3. Yoshiharu Miyamoto
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  4. Mitsuhiro Asakuma
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  10. Kazuhisa Uchiyama
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Correspondence to Fumitoshi Hirokawa.

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Hirokawa, F., Hayashi, M., Miyamoto, Y. et al. Surgical Outcomes and Clinical Characteristics of Elderly Patients Undergoing Curative Hepatectomy for Hepatocellular Carcinoma. J Gastrointest Surg 17, 1929–1937 (2013). https://doi.org/10.1007/s11605-013-2324-0

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  • DOI: https://doi.org/10.1007/s11605-013-2324-0

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