Partial liver resection results in a significantly better long-term survival than locally ablative procedures even in elderly patients

Purpose The number of elderly patients with HCC will increase worldwide in the next years. Therefore, surgeons need to reassess clinical algorithms for the treatment of patients with HCC. We reevaluated a cohort of patients treated in the last 10 years at our hospital, with emphasis on long-term res...

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Bibliographic Details
Published in:Journal of cancer research and clinical oncology 2016-05, Vol.142 (5), p.1099-1108
Main Authors: Bauschke, A., Altendorf-Hofmann, A., Mothes, H., Rauchfuß, F., Settmacher, U.
Format: Article
Language:English
Subjects:
Aged
Cancer Research
Cancer surgery
Carcinoma, Hepatocellular - mortality
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Catheter Ablation - mortality
Female
Follow-Up Studies
Hematology
Hepatectomy - mortality
Humans
Internal Medicine
Liver cancer
Liver Neoplasms - mortality
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Neoplasm Staging
Older people
Oncology
Original Article – Clinical Oncology
Prognosis
Prospective Studies
Retrospective Studies
Survival analysis
Survival Rate
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Summary:Purpose The number of elderly patients with HCC will increase worldwide in the next years. Therefore, surgeons need to reassess clinical algorithms for the treatment of patients with HCC. We reevaluated a cohort of patients treated in the last 10 years at our hospital, with emphasis on long-term results and age. Method A prospectively recorded consecutive series of all patients treated in between January 1995 and December 2014 with curative intent either by partial liver resection or by ablative therapy was analysed. Results At the time of diagnosis, 232 patients were younger than 70 years and 127 patients were aged 70 years and over. In the latter group, solitary tumours, absence of liver cirrhosis and resection therapy were more frequent compared to younger patients. Charlson index, AFP-negative tumours and CLIP score were equally distributed in both groups. Observed survival of older and younger patients was similar but after partial liver resection, younger patients had a better survival than elderly patients, whereas survival in patients treated with ablation was similar in both groups. In the univariate analysis, long-term survival of patients aged 70 years and over was influenced by treatment procedure, number of lesions, liver cirrhosis, Child’s stage and CLIP score. In the multivariate analysis, only treatment procedure and CLIP score were identified as independent predictors of observed survival, and comorbidity was not. Conclusion In patients aged 70 years and over, long-term prognosis is independently influenced by CLIP score and treatment procedure and other findings have only minor influence on long-term survival.
ISSN:0171-5216
1432-1335
DOI:10.1007/s00432-016-2115-6