Assessment of Outcome of Hepatic Resection for Extremely Elderly Patients With a Hepatic Malignancy

Anticancer Res. 2019 Nov;39(11):6325-6332. doi: 10.21873/anticanres.13843.

Abstract

Background/aim: We aimed to assess surgical outcome and long-term survival after elective hepatic resection for hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM) in patients aged 80 years or older.

Patients and methods: This study included 100 patients aged 70 years or older, who underwent hepatic resection for HCC or CRLM between January 2000 and December 2012. Outcomes and clinicopathological data were compared between the elderly (aged 70-79 years; n=84) and extremely elderly groups (aged 80 years or older; n=16).

Results: Incidence of postoperative complications, in-hospital mortality, and postoperative OS in the extremely elderly group were comparable with those of the elderly group. In patients with HCC, the extremely elderly group was associated with shorter DFS (p=0.030) in univariate analysis, while multivariate analysis showed significant and independent factors of cancer recurrence.

Conclusion: Hepatic resection for HCC and CRLM in patients aged 80 years and older may be safe and acceptable with appropriate selection. For HCC in patients aged 80 years and older, hepatic resection may be effective when negative surgical margins can be achieved.

Keywords: Hepatic resection; colorectal liver metastasis; extremely elderly patient; hepatocellular carcinoma.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Colorectal Neoplasms / pathology*
  • Comorbidity
  • Disease-Free Survival
  • Female
  • Hepatectomy* / mortality
  • Hepatectomy* / statistics & numerical data
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Margins of Excision
  • Postoperative Complications
  • Survival Analysis
  • Treatment Outcome