Prediction of postoperative complications in elderly patients with hepatocellular carcinoma

Abstract Background The aim of the present study was to investigate whether advanced age was associated with a higher rate of postoperative complications and identify the predictive factors for postoperative complications in elderly patients with hepatocellular carcinoma (HCC). Methods Between Janua...

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Bibliographic Details
Published in:The Journal of surgical research 2013-12, Vol.185 (2), p.614-619
Main Authors: Ide, Takao, MD, Miyoshi, Atsushi, MD, Kitahara, Kenji, MD, Noshiro, Hirokazu, MD
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Aged, 80 and over
Carcinoma, Hepatocellular - mortality
Carcinoma, Hepatocellular - surgery
Elderly patients
Female
Hepatocellular carcinoma
Humans
Incidence
Liver Neoplasms - mortality
Liver Neoplasms - surgery
Male
Middle Aged
Models, Statistical
Morbidity
Postoperative complication
Postoperative Complications - diagnosis
Postoperative Complications - mortality
Predictive Value of Tests
Retrospective Studies
Risk Factors
Surgery
Young Adult
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Summary:Abstract Background The aim of the present study was to investigate whether advanced age was associated with a higher rate of postoperative complications and identify the predictive factors for postoperative complications in elderly patients with hepatocellular carcinoma (HCC). Methods Between January 2000 and December 2010, 256 patients who underwent hepatectomy for HCC were investigated. Elderly patients were defined as those aged ≥75 y. The clinicopathologic data and outcomes after hepatectomy for 64 elderly and 192 younger patients were retrospectively collected and compared. Results There were no significant differences in the incidence of postoperative complications ( P = 0.936) or the long-term survival after hepatectomy ( P = 0.641) between the elderly and younger patients. In multivariate analysis, the estimation of physiological ability and surgical stress-preoperative risk score (PRS) was an independent risk factor for postoperative morbidity in the elderly patients ( P < 0.01). Moreover, the patients were analyzed according to the PRS for the assessment of their general preoperative condition and liver damage grade based on the hepatic reserve. The rate of postoperative complications in the patients with a PRS ≥0.5 and liver damage B was significantly higher in the elderly patients ( P < 0.01), whereas a PRS and liver damage grade did not affect the incidence of postoperative morbidity in the younger patients ( P = 0.516). Conclusions Hepatectomy for elderly patients with HCC is feasible as well as safe, and the preoperative assessment using the estimation of physiological ability and surgical stress scoring system, combined with the liver damage grade, can help to improve the safety of this procedure for elderly HCC patients.
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2013.07.016