Liver resection in hepatitis B related-hepatocellular carcinoma: Clinical outcomes and safety in elderly patients

作     者：Hai-Qing Wang Jian Yang Lu-Nan Yan Xiao-Wu Zhang Jia-Yin Yang 

作者机构：Department of Liver SurgeryLiver Transplantation CenterWest China Hospital of Sichuan University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第21期

页      面：6620-6625页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：Supported by Grants from the National Science and Technol-ogy Major Project of China No.2012ZX10002-016 and No.2012ZX10002-017 

主　　题：Elderly Hepatocellular carcinoma Hepatectomy Complication Hepatitis B 

摘      要：AIM: To compare the morbidity and mortality in young and elderly hepatocellular carcinoma (HCC) patients undergoing liver resection. METHODS: We retrospectively enrolled 1543 consecutive hepatitis B (HBV)-related HCC patients undergoing elective hepatic resection in our cohort, including 207 elderly patients (= 65 years) and 1336 younger patients ( 65 years). Patient characteristics and clinical outcomes after liver resection were compared between the two groups. RESULTS: Elderly patients had more preoperative comorbidities and lower alanine aminotransferase and aspartate aminotransferase levels. Positive rates for hepatitis B surface antigen (P 0.001), hepatitis B e antigen (P 0.001) and HBV DNA (P = 0.017) were more common in younger patients. Overall complications and their severity classified using the Clavien system were similar in the two groups (33.3% vs 29.6%, P = 0.271). Elderly patients had a higher rate of postoperative cardiovascular complications (3.9% vs 0.6%, P = 0.001), neurological complications (2.9% vs 0.4%, P 0.001) and mortality (3.4% vs 1.2%, P = 0.035), and had more hospital stay requirement (13 d vs 12 d, P 0.001) and more intensive care unit stay (36.7% vs 27.8%, P = 0.008) compared with younger patients. However, postoperative hepatic insufficiency was more common in the younger group (7.7% vs 3.4%, P = 0.024). CONCLUSION: Hepatectomy can be safely performed in elderly patients. Age should not be regarded as a contraindication to liver resection with expected higher complication and mortality rates. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.