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Geriatric assessment as a predictor of postoperative complications in elderly patients with hepatocellular carcinoma

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Abstract

Background

Older patients are considered to have increased risk for complications after major surgery, but age alone is not a reliable predictor of postoperative complications. However, no universal screening test adequately predicts postoperative complications in older patients. This prospective study recorded pertinent baseline geriatric assessment variables to identify risk factors for postoperative complications in hepatocellular carcinoma (HCC) for patients aged ≥70 years who undergo hepatectomy.

Methods

We retrospectively analyzed 71 consecutive patients ≥70 years of age. Patients had geriatric assessments of baseline and later cognition, nutritional and functional status, and burden of comorbidities, completed preoperatively and at 1, 3, and 6 months postoperatively. Postoperative morbidities were recorded.

Results

Postoperative morbidities developed in 18 patients (25 %). Univariate analysis identified serum albumin, operating time and blood loss, cirrhosis, geriatric 8 (G8), and Mini Nutritional Assessment as possible risk factors for postoperative complications, but only G8 < 14 survived multivariate analysis as an independent predictor of complications.

Conclusions

Our findings indicate that the G8 score, based on patients’ nutritional assessments, is a useful screening method for older HCC patients who qualify for elective liver resection. Preoperative G8 scores can help forecast postoperative complications in older HCC patients. Future studies with larger numbers of patients, limited to HCC and liver resections, are needed to verify our results.

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Acknowledgments

This research was partially supported by the Practical Research for Innovative Cancer Control from Japan Agency for Medical Research and Development, AMED.

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Authors and Affiliations

  1. Department of Surgery, Hirakata Hospital, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan

    Masaki Kaibori, Morihiko Ishizaki, Kosuke Matsui, Hiroya Iida, Kentaro Inoue & Masanori Kon

  2. Next-Generation Minimally Invasive Surgery, Kansai Medical University, Hirakata, Osaka, 573-1191, Japan

    Masaki Kaibori

  3. Department of Medical Oncology, Kyorin University School of Medicine, Mitaka, Tokyo, 181-1611, Japan

    Fumio Nagashima

Authors
  1. Masaki Kaibori
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  2. Morihiko Ishizaki
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  3. Kosuke Matsui
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Correspondence to Masaki Kaibori.

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Kaibori, M., Ishizaki, M., Matsui, K. et al. Geriatric assessment as a predictor of postoperative complications in elderly patients with hepatocellular carcinoma. Langenbecks Arch Surg 401, 205–214 (2016). https://doi.org/10.1007/s00423-016-1388-1

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  • DOI: https://doi.org/10.1007/s00423-016-1388-1

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