title: Outcome of repeat hepatectomy in patients with hepatocellular carcinoma aged 75 years and older.
abstract: BACKGROUND
  We sought to evaluate the influence of age on the outcome of repeat hepatectomies in patients > or = 75 years with recurrent hepatocellular carcinoma (HCC).
  
  
  METHODS
  We studied 121 curative repeat hepatectomies retrospectively. Among the 121 patients, 100, 20, and 1 received second, third, and fourth hepatectomies, respectively. The short-term surgical results of a younger group (<75 years; n = 88) and those of an elderly group (> or = 75 years; n = 33) were compared. The long-term prognosis of the patients who underwent second hepatectomies was also compared between a younger group (<75 years; n = 77) and an elderly group (> or = 75 years; n = 23).
  
  
  RESULTS
  The patients in the elderly group displayed more comorbid conditions pre-operatively, including hypertension and cardiovascular diseases, than the younger group (P < .05); however, there was no significant difference in the incidence of postoperative complications or the duration of postoperative hospital stay. The long-term prognosis in the elderly group was almost identical to that in the younger group. The 3-year overall survival rates for the younger group and the elderly group were 83 vs 73% (P = .51). Disease-free, 3-year survival rates for the younger group and the elderly group were 35% vs 38% (P = .88).
  
  
  CONCLUSIONS
  Our findings suggest that advanced age by itself does not have an adverse effect on operative outcomes, including postoperative complications and long-term prognosis. Repeat hepatectomy may, therefore, be justified for recurrent HCC in selected elderly patients.
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima 730-8619, Japan. tsujita@hiroshima-med.jrc.or.jp
authors.forename: Eiji
authors.initials: E
authors.lastname: Tsujita
authors.forename: Tohru
authors.initials: T
authors.lastname: Utsunomiya
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Ohta
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: Tagawa
authors.forename: Ayumu
authors.initials: A
authors.lastname: Matsuyama
authors.forename: Jin
authors.initials: J
authors.lastname: Okazaki
authors.forename: Manabu
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Tsutsui
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Ishida
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000601:surgery*; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D012086:Reoperation / Q000401:mortality*; D012189:Retrospective Studies; D016019:Survival Analysis