title: Surgical outcomes and clinical characteristics of elderly patients undergoing curative hepatectomy for hepatocellular carcinoma.
abstract: BACKGROUND
  The aim of this study was to investigate the clinical characteristics and outcomes of elderly patients (≥ 70 years old) undergoing curative hepatectomy for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Clinicopathological data and treatment outcomes in 100 elderly patients (≥ 70 years old) and 120 control patients (≤ 70 years old) with HCC who underwent curative hepatectomy between 2000 and 2011 were retrospectively collected and compared.
  
  
  RESULTS
  The overall survival rate was similar between the two groups, but the disease-free survival rate was worse in the elderly group when compared with the control group. Prognostic factors for overall and disease-free survival were the same when comparing the two groups. The elderly group had higher rate of females (p = 0.0230), higher hepatitis C virus infection rate (p = 0.0090), higher postoperative pulmonary complication rate (p = 0.0484), lower rate of response to interferon (IFN) therapy (p = 0.0203) and shorter surgical time (p = 0.0337) when compared with the control group. The overall recurrence rate was higher in the elderly group than in the control group (p = 0.0346), but the rate of recurrence within 2 years after the operation was similar when comparing the two groups.
  
  
  CONCLUSIONS
  The survival of elderly patients with HCC was similar to that of younger patients. However, the disease-free survival was worse in elderly patients than in younger patients. Aggressive antiviral therapy (e.g. IFN therapy) may be necessary to improve the disease-free survival, even in elderly patients. Additionally, clinicians should be aware of the risk of pulmonary complications in elderly patients after hepatectomy.
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan, sur122@poh.osaka-med.ac.jp.
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Hirokawa
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Asakuma
authors.forename: Tetsunosuke
authors.initials: T
authors.lastname: Shimizu
authors.forename: Koji
authors.initials: K
authors.lastname: Komeda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takeshita
authors.forename: Yuro
authors.initials: Y
authors.lastname: Shibayama
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D007372:Interferons