LIVER RESECTION FOR HEPATOCELLULAR-CARCINOMA IN THE ELDERLY

Objective: To estimate the effectiveness of hepatic resection on hepat ocellular carcinoma (HCC) in the elderly. Design: Comparison with youn ger patients. Setting: A municipal hospital and a large university hos pital in Japan. Patients: The study included 39 patients (age greater than or equal to 70 years [the elderly group]) and 229 patients (age < 70 years [the younger group]) who underwent hepatic resection from Apr il 1985 to March 1993. The preoperative clinical features (Child's cla ssification, association of cirrhosis and liver functions) were compar able between two groups. The positive rate for hepatitis C virus antib ody was higher in the elderly group (88% vs 59%; P=.016). Main Outcome Measures: Morbidity and survival following operation and the patholog ical features of HCC. Results: The incidence of postoperative hepatic failure was higher in the elderly group (10% vs 2%; P=.018). However, the incidence of operative death in the elderly group (5% vs 1%) as we ll as the incidence of other postoperative complications and rates of long-term survival (75.9% vs 51.6% at 5 years) and disease-free surviv al (30.4% vs 31.0% at 5 years) were similar to those in the younger gr oup. The pathological features of HCC were identical between the two g roups. Conclusion: The outcome of surgical treatment of HCC in the eld erly group was satisfactory when compared with that in the younger gro up.