Safety of hepatectomy for elderly patients with hepatocellular carcinoma.
The number of elderly patients with hepatocellular carcinoma (HCC) has been increasing. Characteristics of elderly HCC patients are a higher proportion of females, a lower rate of positive hepatitis B surface antigen, and a higher rate of positive hepatitis C antibodies. Careful patient selection is vital for performing hepatectomy safely in elderly HCC patients. Treatment strategy should be decided by not only considering tumor stage and hepatic functional reserve, but also physiological status, including comorbid disease. Various assessment tools have been applied to predict the risk of hepatectomy. The reported mortality and morbidity rates after hepatectomy in elderly HCC patients ranged from 0% to 42.9% and from 9% to 51%, respectively. Overall survival rate after hepatectomy in elderly HCC patients at 5 years ranged from 26% to 75.9%. Both short-term and long-term results after hepatectomy for strictly selected elderly HCC patients are almost the same as those for younger patients. However, considering physiological characteristics and the high prevalence of comorbid disease in elderly patients, it is important to assess patients more meticulously and to select them strictly if scheduled to undergo major hepatectomy.
Koichi Oishi, Toshiyuki Itamoto, Toshihiko Kohashi, Yasuhiro Matsugu, Hideki Nakahara, Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima 734-8530, Japan.
Koichi
K
Oishi
Koichi Oishi, Toshiyuki Itamoto, Toshihiko Kohashi, Yasuhiro Matsugu, Hideki Nakahara, Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima 734-8530, Japan.
Toshiyuki
T
Itamoto
Koichi Oishi, Toshiyuki Itamoto, Toshihiko Kohashi, Yasuhiro Matsugu, Hideki Nakahara, Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima 734-8530, Japan.
Toshihiko
T
Kohashi
Koichi Oishi, Toshiyuki Itamoto, Toshihiko Kohashi, Yasuhiro Matsugu, Hideki Nakahara, Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima 734-8530, Japan.
Yasuhiro
Y
Matsugu
Koichi Oishi, Toshiyuki Itamoto, Toshihiko Kohashi, Yasuhiro Matsugu, Hideki Nakahara, Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima 734-8530, Japan.
Hideki
H
Nakahara
Koichi Oishi, Toshiyuki Itamoto, Toshihiko Kohashi, Yasuhiro Matsugu, Hideki Nakahara, Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima 734-8530, Japan.
Mikiya
M
Kitamoto
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D003661:Decision Support Techniques; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D061214:Patient Safety; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
Elderly; Hepatectomy; Hepatocellular carcinoma