title: Hepatic resection for hepatocellular carcinoma in super-elderly patients aged 80 years and older in the first decade of the 21st century.
abstract: OBJECTIVE
  We evaluated the preoperative and postoperative characteristics and prognosis of super-elderly patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Four hundred and thirty-one patients who underwent hepatic resection for HCC were classified into three groups according to their age at the time of surgery: super-elderly (≥80 years; n = 20), elderly (70-80 years; n = 172) and younger (<70 years; n = 239). We compared the clinical characteristics, preoperative and postoperative factors and prognosis among the groups to evaluate whether liver resection is appropriate for super-elderly patients.
  
  
  RESULTS
  The liver function was not significantly different among the groups. The proportion of patients with preoperative cardiovascular and respiratory disease and hypertension was higher in the super-elderly group compared to the other groups. The super-elderly group had shorter operations and reduced hemorrhage rates compared to the other groups. Postoperative cardiovascular complications and delirium were more frequently observed in the super-elderly group. The overall and tumor-free survival rates were not significantly different among the groups. Super-elderly patients had a lower rate of liver or HCC-related death and a higher rate of death due to other causes than the other groups.
  
  
  CONCLUSIONS
  Super-elderly HCC patients who are appropriately evaluated and selected might have a favorable prognosis after undergoing hepatic resection.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan, m1166658@med.osaka-cu.ac.jp.
authors.forename: Akinori
authors.initials: A
authors.lastname: Nozawa
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Chikaharu
authors.initials: C
authors.lastname: Sakata
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Urata
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Nishioka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Genya
authors.initials: G
authors.lastname: Hamano
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Suehiro
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
references.citation: Surgery. 2011 May;149(5):680-8
references.pmid: 21316725
references.citation: Br J Surg. 1987 Jun;74(6):471-3
references.pmid: 3038252
references.citation: HPB (Oxford). 2002;4(2):99; author reply 99-100
references.pmid: 18332933
references.citation: Hepatol Res. 2012 May;42(5):454-8
references.pmid: 22295877
references.citation: World J Surg. 2005 Sep;29(9):1101-5
references.pmid: 16088422
references.citation: Ann Surg. 1995 Oct;222(4):426-34; discussion 434-7
references.pmid: 7574924
references.citation: J Gastrointest Surg. 2009 Sep;13(9):1627-35
references.pmid: 19506976
references.citation: Surgery. 1999 Mar;125(3):332-8
references.pmid: 10076619
references.citation: Surgery. 2010 May;147(5):696-703
references.pmid: 20015526
references.citation: Ann Surg. 2004 Aug;240(2):205-13
references.pmid: 15273542
references.citation: Am J Gastroenterol. 1999 Sep;94(9):2460-6
references.pmid: 10484009
references.citation: J Surg Oncol. 2011 Sep 1;104(3):284-91
references.pmid: 21462192
references.citation: Br J Surg. 1997 Oct;84(10):1386-90
references.pmid: 9361595
references.citation: Hepatogastroenterology. 2004 Jan-Feb;51(55):219-23
references.pmid: 15011868
references.citation: Lancet. 2012 Mar 31;379(9822):1245-55
references.pmid: 22353262
references.citation: World J Surg. 2009 Sep;33(9):1927-32
references.pmid: 19603226
references.citation: Surgery. 1993 Feb;113(2):148-54
references.pmid: 8381563
references.citation: Arch Surg. 1994 Aug;129(8):846-50
references.pmid: 8048856
references.citation: Hepatogastroenterology. 2012 Jul-Aug;59(117):1553-5
references.pmid: 22683972
references.citation: Am J Surg. 1988 Feb;155(2):238-41
references.pmid: 2829639
references.citation: J Surg Oncol. 2006 Mar 1;93(3):186-93
references.pmid: 16482597
references.citation: Hepatol Res. 2007 Sep;37(9):676-91
references.pmid: 17617112
references.citation: Semin Surg Oncol. 1993 Jul-Aug;9(4):298-304
references.pmid: 8210909
references.citation: Exp Gerontol. 2005 Aug-Sep;40(8-9):650-9
references.pmid: 16102930
references.citation: J Am Coll Surg. 2001 Jan;192(1):38-46
references.pmid: 11192921
references.citation: Hepatogastroenterology. 1997 Mar-Apr;44(14):514-8
references.pmid: 9164528
references.citation: World J Surg. 2008 Oct;32(10):2223-9
references.pmid: 18642042
references.citation: Surgery. 2011 May;149(5):713-24
references.pmid: 21236455
references.citation: World J Surg. 2004 Oct;28(10):982-6
references.pmid: 15573252
references.citation: G Chir. 2007 Nov-Dec;28(11-12):419-24
references.pmid: 18035008
references.citation: J Surg Oncol. 2009 Mar 1;99(3):154-60
references.pmid: 19123236
references.citation: Ann Surg. 1990 Feb;211(2):141-5
references.pmid: 2301993