-Original-

Surgical Outcomes and Prognostic Factors in Elderly Patients (75 Years or Older) with Hepatocellular Carcinoma Who Underwent Hepatectomy

Nobuhiko Taniai, Hiroshi Yoshida, Masato Yoshioka, Youichi Kawano and Eiji Uchida

Department of Surgery, Nippon Medical School

Background: Whether hepatic resection is indicated for elderly patients with hepatocellular carcinoma (HCC) remains controversial.
Methods: This retrospective study evaluated surgical outcomes and prognostic factors in elderly patients with HCC who underwent hepatectomy. Overall survival rates and disease-free survival rates after hepatectomy were compared between 63 patients with HCC who were 75 years or older (elderly group) and 353 patients with HCC who were younger than 75 years (younger group). Prognostic factors in the elderly group were evaluated by means of multivariate analysis with a Cox's proportional-hazards model.
Results: Overall survival rates at 3 and 5 years were respectively 56.2% and 40.2% in the elderly group and 63.4% and 46.6% in the younger group. Disease-free survival rates at these times were 34.9% and 34.9% in the elderly group and 30.8% and 21.5% in the younger group. These differences were not significant. Multivariate analysis revealed a significant association between Child-Pugh class and outcomes (P=0.01).
Conclusions: The safety and survival benefits of hepatectomy in carefully selected elderly patients with HCC are similar to those in younger patients.

J Nippon Med Sch 2013; 80: 426-432

Keywords
hepatocellular carcinoma, elderly patients, prognostic factor, survival rate

Correspondence to
Nobuhiko Taniai, MD, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
Taniain@nms.ac.jp

Received, May 7, 2013
Accepted, July 3, 2013