RIGHT HEPATIC LOBECTOMY IN ELDERLY PATIENTS WITH HEPATOCELLULAR-CARCINOMA

Background/Aims: The outcome of hepatectomy in elderly patients with h epatocellular carcinoma have been reported, however neither the morpho logical nor functional hepatic regeneration in elderly patients have b een fully investigated. Materials and Methods: Fifty-six patients with hepatocellular carcinoma, who underwent a right hepatic Lobectomy ove r an 8-year period, were classified into three groups according to the ir age; group 1 (n=7), more than 70 years of age; group 2 (n=40), pati ents from 50 to 69 years of age and group 3 (n=9), under 50 years of a ge. There were no significant differences regarding backgrounds or int ra-operative parameters among the three groups. The perioperative hepa tic function, postoperative complications and the regeneration rate of the remnant left lobe at 1 month after operation were compared. Resul ts: No differences were found in the regeneration rate, however, the l evels of the hepaplastin test and lecithin:cholesterol acyltransferase at 7 days after hepatectomy in group 1 (31.3%, 8.8U) were significant ly lower than, those in groups 2 and 3 (37.4%, 18.4U; 47.9%, 29.4U, re spectively). The incidence of hospital death due to hepatic failure in group 1 (42.9%) was also significantly higher than that of group 2 (5 .0%) or group 3 (0%). Conclusion: The decline of postoperative protein synthesis regardless of the voluminal regeneration is a characteristi c of the elderly. This phenomenon might thus be art important promoter of postoperative hepatic failure which remains unpredictable using an y type of examination. Therefore, at this time, a major hepatectomy is not recommended as a viable treatment alternative in the elderly.