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. 2021 Mar 23:8:155-165.
doi: 10.2147/JHC.S297296. eCollection 2021.

Short- and Long-Term Outcomes After Hepatectomy in Elderly Patients with Hepatocellular Carcinoma: An Analysis of 229 Cases from a Developing Country

Danijel Galun  1   2 , Aleksandar Bogdanovic  1   2 , Marko Zivanovic  1 , Marinko Zuvela  1   2
Affiliations

Short- and Long-Term Outcomes After Hepatectomy in Elderly Patients with Hepatocellular Carcinoma: An Analysis of 229 Cases from a Developing Country

Danijel Galun et al. J Hepatocell Carcinoma. .

Abstract

Background: The number of elderly patients with HCC who undergo liver resection is increasing. Because of the advanced age of the patients, increased postoperative morbidity and reduced overall survival are expected in this population. The study aim was to compare clinicopathologic and operative features, short- and long-term outcomes among hepatocellular carcinoma (HCC) patients from three age groups undergoing potentially curative liver resection in a developing country.

Methods: Prospectively collected data relating to 229 patients who underwent curative-intent liver resection from January 2009 until December 2018 were analyzed. The patients were divided into two age groups: G1 was below 70 years old (n=151) and G2 was 70 years old and older (n=78). Demographic, clinical, operative data, short- and long-term outcomes were compared between the two groups. Univariate and multivariate analyses of prognostic factors were performed.

Results: The mean overall morbidity rate of the patients was 31.1% (G1), and 46.2% (G2) by age group. Postoperative morbidity was significantly higher in the G2 group (p=0.03). There was no difference in major morbidity between the two groups (p=0.214). No significant difference in mortality rate and overall survival was found between the study groups (p=0.280, p=0.383). Both age ≥70 years (ie, G2 group) and liver cirrhosis were identified as prognostic factors for postoperative morbidity, and a Child-Pugh score B as a negative prognostic factor for overall survival. In subgroup analysis of patients with cirrhosis, age ≥70, diabetes mellitus and perioperative transfusion were identified as prognostic factors for postoperative morbidity.

Conclusion: The study confirmed the safety and feasibility of liver resection in elderly patients with HCC. However, appropriate patient selection among the elderly is mandatory in order to improve short- and long-term outcomes.

Keywords: elderly; hepatectomy; hepatocellular carcinoma.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Overall survival of the two age cohorts.
See this image and copyright information in PMC

References

    1. Japan Ministry of Internal Affairs and Communications. Statistics Bureau. Available from: http://www.stat.go.jp/data/topics/topi721.html. Accessed September15, 2013.
    1. The European Commission and the Economic Policy Committee (AWG). The 2012 Ageing Report: economic and Budgetary Projections for the EU27 Member States (2010–2060). Brussels: European Union; 2012.
    1. Administration on Ageing, Administration for Community Living. A profile of Older Americans 2013. Washington: US Department of Health and Human Services; 2014.
    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA-Cancer J Clin. 2018;68:394–424. doi: 10.3322/caac.21492 - DOI - PubMed
    1. Bishayee A. The role of inflammation and liver cancer. Adv Exp Med Biol. 2014;816:401–435. - PubMed

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