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Comparative Study
. 2016 May;142(5):1099-108.
doi: 10.1007/s00432-016-2115-6. Epub 2016 Jan 18.

Partial liver resection results in a significantly better long-term survival than locally ablative procedures even in elderly patients

A Bauschke  1 , A Altendorf-Hofmann  2 , H Mothes  2 , F Rauchfuß  2 , U Settmacher  2
Affiliations
Comparative Study

Partial liver resection results in a significantly better long-term survival than locally ablative procedures even in elderly patients

A Bauschke et al. J Cancer Res Clin Oncol. 2016 May.

Abstract

Purpose: The number of elderly patients with HCC will increase worldwide in the next years. Therefore, surgeons need to reassess clinical algorithms for the treatment of patients with HCC. We reevaluated a cohort of patients treated in the last 10 years at our hospital, with emphasis on long-term results and age.

Method: A prospectively recorded consecutive series of all patients treated in between January 1995 and December 2014 with curative intent either by partial liver resection or by ablative therapy was analysed.

Results: At the time of diagnosis, 232 patients were younger than 70 years and 127 patients were aged 70 years and over. In the latter group, solitary tumours, absence of liver cirrhosis and resection therapy were more frequent compared to younger patients. Charlson index, AFP-negative tumours and CLIP score were equally distributed in both groups. Observed survival of older and younger patients was similar but after partial liver resection, younger patients had a better survival than elderly patients, whereas survival in patients treated with ablation was similar in both groups. In the univariate analysis, long-term survival of patients aged 70 years and over was influenced by treatment procedure, number of lesions, liver cirrhosis, Child's stage and CLIP score. In the multivariate analysis, only treatment procedure and CLIP score were identified as independent predictors of observed survival, and comorbidity was not.

Conclusion: In patients aged 70 years and over, long-term prognosis is independently influenced by CLIP score and treatment procedure and other findings have only minor influence on long-term survival.

Keywords: Elderly patient; HCC; Liver resection; Survival.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Long-term survival after partial liver resection in patients aged 70 years and over, and under 70 years, respectively
Fig. 2
Fig. 2
Long-term survival after local ablative therapy in patients aged 70 years and over, and under 70 years, respectively
Fig. 3
Fig. 3
Long-term survival depending on CLIP score in patients aged 70 years and over
Fig. 4
Fig. 4
Long-term survival after local ablative therapy or partial liver resection in patients aged 70 years and over
Fig. 5
Fig. 5
Long-term survival of patients aged 70 years and over who underwent resection depending on CLIP score
Fig. 6
Fig. 6
Long-term survival of patients aged 70 years and over who underwent local ablative procedures depending on CLIP score
See this image and copyright information in PMC

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