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Age not a contraindication to hepatocellular carcinoma resection

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Last Modified: November 1, 2001

Last Updated: 2001-02-01 15:00:45 EST (Reuters Health) - Elderly patients may benefit as much from hepatic resection for hepatocellular carcinoma (HCC) as young patients, according to a report published in the January issue of the Journal of the American College of Surgeons.

Dr. Kazuhiro Hanazaki and colleagues from the Shinshu University School of Medicine in Matsumoto, Japan compared the clinical outcomes following hepatic resection of 103 HCC patients who were 70 years of age or older with 283 HCC patients who were younger than 70 years of age. The older group had a higher incidence of comorbid conditions and hepatitic C infection, but otherwise the groups were equivalent.

The authors found that postoperative complications, operative mortality, and overall hospital death rates were not significantly different between the groups. In addition, overall 3- and 5-year survival rates did not differ significantly between the groups. Just over 50% of patients were alive at 3 years and close to 40% of patients were alive at 5 years. Disease-free survival rates were also not significantly different between the groups.

On multivariate analysis, the presence of cirrhosis and vascular invasion were independent significant predictors of poor overall survival, the researchers note.

"Our results indicate that the surgical strategy for elderly patients with HCC should be identical to that in younger patients," the investigators write. However, the authors acknowledge that there may have been some patient selection bias and believe that "further examination may be necessary to conclude definitely whether age has any influence on outcomes of resection for HCC."

Overall, Dr. Hanazaki's team concludes that "hepatic resection for HCC is safe in selected elderly patients, and the improved results in recent years indicate that more elderly patients could benefit from surgical management."

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