Liver resection for hepatocellular carcinoma in octogenarians

Background, Liver resection is risky in patients aged greater than or equal to 80 years. Because of short life expectancies and involved nonoperative modalities, the role of liver resection in octogenarians with hepatocellula r carcinoma (HCC) is unclear: Methods. A retrospective I review of the operative results of 260 patients with HCC between 1991 and 1997 was performed. According to the age at the t ine of operation, these patients was divided into 2 groups. Group I compris ed 21 patients aged greater than or equal to 80 years, and group 2 comprise d the other 239 younger patents. The backgrounds, pathologic features of th e tumor and operative results of the patients were compared. Results, Octogenarians had a higher incidence of associated,medical disease s, a higher incidence of negative serum hepatitis B surface antigen, a lowe r alpha-fetoprotein level, and a higher indocyanine green retention rate. A lthough octogenarians had a longer postoperative hospital stay, there were no significant differences between the 2 group regarding operative morbidit y and mortality. The 5-year disease-fi ee and actuarial survival rates for octogenarians and younger patients were 50.6% and 35.3% (P =. 15) and 40.9% and 59.3% (P =.46), respectively. Conclusion, Under meticulous preoperative assessments and postoperative car e, liver resection for HCC is justified in selected octogenarians, with sho rt- and long-term results comparable to those of younger patients.