Hepatic resection for hepatocellular carcinoma in the elderly

Abstract

Background and objectives: Aging of the population has significantly increased the number of elderly patients undergoing surgery for hepatocellular carcinoma (HCC). We aimed to compare the results of hepatectomy for HCC in patients >/=70 years old with those for younger patients.

Methods: Clinicopathological data and outcomes for 155 elderly patients and 333 younger patients with HCC who underwent hepatectomy between 1992 and 2007 were retrospectively compared.

Results: The elderly group had a higher incidence of associated diseases, but had better preoperative liver function. Although postoperative delirium was more common in the elderly group, there were no significant differences between the two groups with regard to operative morbidity, hospital death, disease-free survival, and overall survival. The overall recurrence rate was significantly higher in the elderly patients with alcohol abuse than in younger patients with alcohol abuse. Multivariate analysis revealed that preoperative alcohol abuse was a prognostic factor for elderly patients.

Conclusions: The short-term and long-term outcomes of surgery for HCC were similar in elderly and younger patients. Elderly patients with preoperative alcohol abuse should be followed closely, even after R0 surgery, because alcohol abuse is strongly correlated with postoperative recurrence and worse survival.