Takenaka K, Shimada M, Higashi H, Adachi E, Nishizaki T, Yanaga K, Matsumata T, Ikeda T, Sugimachi K
Department of Surgery, Fukuoka City Hospital, Japan.
Arch Surg. 1994 Aug;129(8):846-50. doi: 10.1001/archsurg.1994.01420320072014.
To estimate the effectiveness of hepatic resection on hepatocellular carcinoma (HCC) in the elderly.
Comparison with younger patients.
A municipal hospital and a large university hospital in Japan.
The study included 39 patients (age > or = 70 years [the elderly group]) and 229 patients (age < 70 years [the younger group]) who underwent hepatic resection from April 1985 to March 1993. The preoperative clinical features (Child's classification, association of cirrhosis and liver functions) were comparable between two groups. The positive rate for hepatitis C virus antibody was higher in the elderly group (88% vs 59%; P = .016).
Morbidity and survival following operation and the pathological features of HCC.
The incidence of postoperative hepatic failure was higher in the elderly group (10% vs 2%; P = .018). However, the incidence of operative death in the elderly group (5% vs 1%) as well as the incidence of other postoperative complications and rates of long-term survival (75.9% vs 51.6% at 5 years) and disease-free survival (30.4% vs 31.0% at 5 years) were similar to those in the younger group. The pathological features of HCC were identical between the two groups.
The outcome of surgical treatment of HCC in the elderly group was satisfactory when compared with that in the younger group.
评估肝切除术治疗老年肝细胞癌（HCC）的有效性。
与年轻患者进行比较。
日本一家市级医院和一家大型大学医院。
该研究纳入了1985年4月至1993年3月期间接受肝切除术的39例患者（年龄≥70岁[老年组]）和229例患者（年龄<70岁[年轻组]）。两组术前临床特征（Child分级、肝硬化及肝功能情况）具有可比性。老年组丙型肝炎病毒抗体阳性率更高（88%对59%；P = 0.016）。
术后发病率、生存率以及HCC的病理特征。
老年组术后肝衰竭发生率更高（10%对2%；P = 0.018）。然而，老年组手术死亡率（5%对1%）、其他术后并发症发生率、长期生存率（5年时75.9%对51.6%）以及无病生存率（5年时30.4%对31.0%）与年轻组相似。两组HCC的病理特征相同。
与年轻组相比，老年组HCC手术治疗的结果令人满意。
