Multicenter analysis of long-term oncologic outcomes of hepatectomy for elderly patients with hepatocellular carcinoma. Issue 9 (September 2020)

• Record Type: Journal Article
• Authors: Xing, Hao; Liang, Lei; Wang, Hong; Zhou, Ya-Hao; Pei, You-Liang; Li, Chao; Zeng, Yong-Yi; Gu, Wei-Min; Chen, Ting-Hao; Li, Jie; Zhang, Yao-Ming; Wang, Ming-Da; Zhang, Wan-Guang; Pawlik, Timothy M.; Lau, Wan Yee; Shen, Feng; Wu, Meng-Chao; Yang, Tian
• Is Part Of: HPB. Volume 22:Issue 9(2020)
• Page Start: 1314
• Page End: 1323
• Publication Date: 2020-09
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2019.12.006
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Aging of the population and prolonged life expectancy have significantly increased the number of elderly patients undergoing hepatectomy for hepatocellular carcinoma (HCC). However, potential benefits, especially long-term oncologic outcomes of hepatectomy for elderly patients with HCC remain unclear. Method: Patients treated with curative-intent hepatectomy for HCC in 8 Chinese hospitals were enrolled. Patients were divided into the elderly (≥70 years old) and younger (<70 years old) groups. Overall survival (OS), cancer-specific survival (CSS), and time-to-recurrence (TTR) were compared. Risk factors of CSS and TTR were evaluated by univariable and multivariable competing-risk regression analyses. Results: Of 2134 patients, 259 (12.1%) and 1875 (87.9%) were elderly and younger aged, respectively. Postoperative 30-day and 90-day mortality was comparable among elderly and younger patients. Compared with younger patients, the elderly had a worse 5-year OS (49.4% vs. 55.3%, P = 0.032), yet a better 5-year CCS (74.5% vs. 61.0%, P = 0.005) and a lower 5-year TTR (33.7% vs. 44.9%, P < 0.001), respectively. Multivariable analyses identified that elder age was independently associated with more favorable CSS (HR 0.74, 95%CI 0.58–0.90, P = 0.011) and TTR (0.69, 0.53–0.88, P < 0.001) but was not associated with OS ( P = 0.136). Conclusions: Age by itself is not a contraindication to surgery, and selected elderly patients with HCC can benefit from hepatectomy. Compared with younger patients, elderly patients have noninferior oncologic outcomes following hepatectomy for HCC.