title: Liver resection in hepatitis B related-hepatocellular carcinoma: clinical outcomes and safety in elderly patients.
abstract: OBJECTIVE
  To compare the morbidity and mortality in young and elderly hepatocellular carcinoma (HCC) patients undergoing liver resection.
  
  
  METHODS
  We retrospectively enrolled 1543 consecutive hepatitis B (HBV)-related HCC patients undergoing elective hepatic resection in our cohort, including 207 elderly patients (≥ 65 years) and 1336 younger patients (＜ 65 years). Patient characteristics and clinical outcomes after liver resection were compared between the two groups.
  
  
  RESULTS
  Elderly patients had more preoperative comorbidities and lower alanine aminotransferase and aspartate aminotransferase levels. Positive rates for hepatitis B surface antigen (P ＜ 0.001), hepatitis B e antigen (P ＜ 0.001) and HBV DNA (P = 0.017) were more common in younger patients. Overall complications and their severity classified using the Clavien system were similar in the two groups (33.3% vs 29.6%, P = 0.271). Elderly patients had a higher rate of postoperative cardiovascular complications (3.9% vs 0.6%, P = 0.001), neurological complications (2.9% vs 0.4%, P ＜ 0.001) and mortality (3.4% vs 1.2%, P = 0.035), and had more hospital stay requirement (13 d vs 12 d , P < 0.001) and more intensive care unit stay (36.7% vs 27.8%, P = 0.008) compared with younger patients. However, postoperative hepatic insufficiency was more common in the younger group (7.7% vs 3.4%, P = 0.024).
  
  
  CONCLUSIONS
  Hepatectomy can be safely performed in elderly patients. Age should not be regarded as a contraindication to liver resection with expected higher complication and mortality rates.
authors.affiliation: Hai-Qing Wang, Jian Yang, Lu-Nan Yan, Xiao-Wu Zhang, Jia-Yin Yang, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Hai-Qing
authors.initials: HQ
authors.lastname: Wang
authors.affiliation: Hai-Qing Wang, Jian Yang, Lu-Nan Yan, Xiao-Wu Zhang, Jia-Yin Yang, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.affiliation: Hai-Qing Wang, Jian Yang, Lu-Nan Yan, Xiao-Wu Zhang, Jia-Yin Yang, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Lu-Nan
authors.initials: LN
authors.lastname: Yan
authors.affiliation: Hai-Qing Wang, Jian Yang, Lu-Nan Yan, Xiao-Wu Zhang, Jia-Yin Yang, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Xiao-Wu
authors.initials: XW
authors.lastname: Zhang
authors.affiliation: Hai-Qing Wang, Jian Yang, Lu-Nan Yan, Xiao-Wu Zhang, Jia-Yin Yang, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jia-Yin
authors.initials: JY
authors.lastname: Yang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006509:Hepatitis B / Q000150:complications* / Q000601:surgery*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens
keywords: Complication; Elderly; Hepatectomy; Hepatitis B; Hepatocellular carcinoma