Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Anticancer Res. 2019 Nov;39(11):6325-6332. doi: 10.21873/anticanres.13843.
BACKGROUND/AIM: We aimed to assess surgical outcome and long-term survival after elective hepatic resection for hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM) in patients aged 80 years or older.
This study included 100 patients aged 70 years or older, who underwent hepatic resection for HCC or CRLM between January 2000 and December 2012. Outcomes and clinicopathological data were compared between the elderly (aged 70-79 years; n=84) and extremely elderly groups (aged 80 years or older; n=16).
Incidence of postoperative complications, in-hospital mortality, and postoperative OS in the extremely elderly group were comparable with those of the elderly group. In patients with HCC, the extremely elderly group was associated with shorter DFS (p=0.030) in univariate analysis, while multivariate analysis showed significant and independent factors of cancer recurrence.
Hepatic resection for HCC and CRLM in patients aged 80 years and older may be safe and acceptable with appropriate selection. For HCC in patients aged 80 years and older, hepatic resection may be effective when negative surgical margins can be achieved.
背景/目的:我们旨在评估 80 岁或以上行择期肝切除术治疗肝细胞癌(HCC)和结直肠癌肝转移(CRLM)患者的手术结果和长期生存。
本研究纳入了 2000 年 1 月至 2012 年 12 月间行肝切除术治疗 HCC 或 CRLM 的 100 例 70 岁或以上的患者。比较了高龄组(70-79 岁;n=84)和超高龄组(80 岁或以上;n=16)的结局和临床病理数据。
超高龄组的术后并发症发生率、住院死亡率和术后 OS 与高龄组相当。在 HCC 患者中,单因素分析显示超高龄组的 DFS 较短(p=0.030),而多因素分析显示癌症复发是显著且独立的因素。
对于 80 岁及以上的患者,行 HCC 和 CRLM 的肝切除术可能是安全和可接受的,但需要适当的选择。对于 80 岁及以上的 HCC 患者,当能够达到阴性切缘时,肝切除术可能是有效的。