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. 2014 Jun 7;20(21):6620-5.
doi: 10.3748/wjg.v20.i21.6620.

Liver resection in hepatitis B related-hepatocellular carcinoma: clinical outcomes and safety in elderly patients

Hai-Qing Wang  1 , Jian Yang  1 , Lu-Nan Yan  1 , Xiao-Wu Zhang  1 , Jia-Yin Yang  1
Affiliations

Liver resection in hepatitis B related-hepatocellular carcinoma: clinical outcomes and safety in elderly patients

Hai-Qing Wang et al. World J Gastroenterol. .

Abstract

Aim: To compare the morbidity and mortality in young and elderly hepatocellular carcinoma (HCC) patients undergoing liver resection.

Methods: We retrospectively enrolled 1543 consecutive hepatitis B (HBV)-related HCC patients undergoing elective hepatic resection in our cohort, including 207 elderly patients (≥ 65 years) and 1336 younger patients (＜ 65 years). Patient characteristics and clinical outcomes after liver resection were compared between the two groups.

Results: Elderly patients had more preoperative comorbidities and lower alanine aminotransferase and aspartate aminotransferase levels. Positive rates for hepatitis B surface antigen (P ＜ 0.001), hepatitis B e antigen (P ＜ 0.001) and HBV DNA (P = 0.017) were more common in younger patients. Overall complications and their severity classified using the Clavien system were similar in the two groups (33.3% vs 29.6%, P = 0.271). Elderly patients had a higher rate of postoperative cardiovascular complications (3.9% vs 0.6%, P = 0.001), neurological complications (2.9% vs 0.4%, P ＜ 0.001) and mortality (3.4% vs 1.2%, P = 0.035), and had more hospital stay requirement (13 d vs 12 d , P < 0.001) and more intensive care unit stay (36.7% vs 27.8%, P = 0.008) compared with younger patients. However, postoperative hepatic insufficiency was more common in the younger group (7.7% vs 3.4%, P = 0.024).

Conclusion: Hepatectomy can be safely performed in elderly patients. Age should not be regarded as a contraindication to liver resection with expected higher complication and mortality rates.

Keywords: Complication; Elderly; Hepatectomy; Hepatitis B; Hepatocellular carcinoma.

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