Liver resection in the aged (seventy years or older) with hepatocellular carcinoma.
BACKGROUND
Thirty-two patients who were 70 years of age or older underwent hepatic resection in the treatment of hepatocellular carcinoma. There were 25 men and 7 women. Age ranged from 70 to 84 years, averaging 74 +/- 3 years (mean +/- SD). Underlying liver diseases were associated in all patients but one, cirrhosis of the liver in 22, and chronic hepatitis in nine.


RESULTS
The operative mortality rate within 1 month was 12.5%, and the overall in-hospital death rate was 18.8%. The 5-year survival rate was 17.6% for all patients and 24.3% when six hospital deaths were excluded. The Child's grade was a good predictor for early and late morbidity and death, the 5-year survival rate of patients with Child's class A disease being 30%. Retrospective comparisons were conducted between the current patients and patients younger than 50 years old who had been operated on during the same period: resectability rate, 61.5% versus 57.8%; hospital mortality rate, 18.8% versus 11.6%; and 5-year survival rate, 24.3% versus 48.6%, respectively.


CONCLUSIONS
These results seem to indicate that the treatment policy of hepatocellular carcinoma in the aged should be identical to that in young people.
Second Department of Surgery, Shimane Medical University, Izumo, Japan.
N
N
Nagasue
Y C
YC
Chang
Y
Y
Takemoto
H
H
Taniura
H
H
Kohno
T
T
Nakamura
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate