Hepatic resection for elderly patients with hepatocellular carcinoma: a systematic review of more than 17,000 patients

Zhao, Lingyun; Huo, Rong‐Rui; Xiang, Xiao; Torzilli, Guido; Zheng, Ming‐Hua; Yang, Tian; Liang, Xin-Min; Huang, Xi; Tang, Pei-Ling; Xiang, Bang‐De; Li, Le‐Qun; You, Xue‐Mei; Zhong, Jian‐Hong

doi:10.1080/17474124.2018.1517045

Cited by 20 publications

(18 citation statements)

References 69 publications

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“…In recent decades, many preoperative clinicopathologic variables were used to predict postoperative liver dysfunction, perioperative mortality, and long-term overall survival, such as serum markers of liver fibrosis,14 splenic thickness,15 neutrophil-to-lymphocyte ratio,16 Controlling Nutritional Status Score,5 body-mass index,17 and age18. Estimation of hepatic functional reserve in the future remnant liver is critical for HCC patients before hepatic resection.…”

Section: Discussionmentioning

confidence: 99%

Serum Prealbumin is Negatively Associated with Survival in Hepatocellular Carcinoma Patients after Hepatic Resection

Liao¹,

Peng²,

Jia³

et al. 2019

J. Cancer

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Objective: Low serum prealbumin levels are associated with poor prognoses in some type of cancers. However, the role of prealbumin in patients with hepatocellular carcinoma (HCC) is unknown. The present study aimed to investigate the role of serum prealbumin levels in long-term survival for HCC patients after hepatic resection. Methods: HCC patients who underwent hepatic resection from June 2007 to December 2015 were retrospectively analyzed in a tertiary liver center. Patients were classified as having normal or reduced serum prealbumin based on a cut-off value of 200 mg/L. Overall survival and recurrence rate were analyzed between groups. Propensity score analysis was used to reduce bias due to other patient differences at baseline. Results: A total of 1349 HCC patients who underwent hepatic resection were enrolled on this study, including 1168 (86.6%) male and 181 (13.4%) female. Patients with normal serum prealbumin had significantly higher overall survival than those with reduced serum prealbumin (P < 0.001). Similar findings were observed after propensity analysis and subgroup analysis based on liver cirrhosis. Moreover, patients with normal serum prealbumin had a significantly lower recurrence rate than those with reduced serum prealbumin (P < 0.001). Conclusions: Low preoperative level of serum prealbumin is associated with poor long-term survival in patients with HCC after hepatic resection. Low serum prealbumin may be a marker to identify patients at high risk of poor prognosis after hepatic resection.

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Section: Discussionmentioning

confidence: 99%

Serum Prealbumin is Negatively Associated with Survival in Hepatocellular Carcinoma Patients after Hepatic Resection

Liao¹,

Peng²,

Jia³

et al. 2019

J. Cancer

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“…[9,11,13,17] Although elderly patients are more likely to experience complications after surgery, previous studies have reported no significant difference between elderly and nonelderly patients in terms of the incidence of postoperative complications or hospitalization stay after surgery. [9,10,19,20] Although we did not assess post-treatment complications because they were not detailed in KCCR database, SR may be safely applied to elderly patients with good performance status or well-preserved liver function based on the results of these previous studies. [9,10,19,20] In fact, in the present study, reserved liver function was good in most BCLC 0-A staged patients.…”

Section: Discussionmentioning

confidence: 99%

Effective therapeutic options for elderly patients with hepatocellular carcinoma

Shin

Jin

et al. 2019

Medicine

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“…In a recent review by Cho et al [6] , curative intended treatments for hepatocellular cancer with resection or radiofrequency ablation (RFA) was found to be safe in selected patients over the age of 75 [5] , namely patients who generally had less severe underlying liver disease, were predominantly female and had more well-differentiated tumours, indicating that there was a clear selection bias when comparing the elderly with younger HCC patients. With careful selection, excellent results of resection can be achieved [7][8][9] . However, with increasing age, comorbidities amass and resective surgery is often not deemed appropriate and patients can be offered local ablative treatments with RFA instead without having age or comorbidities affecting outcome [10,11] .…”

Section: Introductionmentioning

confidence: 99%

Microwave ablation of hepatocellular carcinomas in octogenarians

Freedman¹

2020

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Aim: To evaluate wether it is safe and meaningful to treat octogenarians with microwave ablation for hepatocellular carcinoma. With an ageing population being healthier than previous generations, old limits for treating disease founded on patient age need to be revised. One of the most common tumour related death causes is hepatocellular carcinoma (HCC). With the development of minimally invasive therapies with curative potential, new ground is being broken offering treatments to older patients in the hope of achieving prolongation and better quality of life. Methods: In this retrospective single centre study of patients having a first microwave ablation therapy for HCC in a national referral centre for ablative liver treatments, septuagenarians (n = 161, age 70-80) were compared with octogenarians (n = 32, age 80-90). Results: Octogenarians selected for microwave ablation of HCC at a regional multidisciplinary team conference have similar outcomes as their younger control group. Survival, complications and length of stay are not different. Conclusion: Octogenarians who are fit for ablative treatment of HCC should not be disqualified on grounds of age, recognising that this group has an obvious immortality, or lead-time, bias as well as a probable selection bias in part explaining their good results.

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Hepatic resection for elderly patients with hepatocellular carcinoma: a systematic review of more than 17,000 patients

Abstract: Though old age may increase the risk of hospital mortality for patients with HCC after hepatic resection, elderly patients can obtain acceptable long-term prognoses from hepatic resection.

Cited by 20 publications

References 69 publications

Serum Prealbumin is Negatively Associated with Survival in Hepatocellular Carcinoma Patients after Hepatic Resection

Serum Prealbumin is Negatively Associated with Survival in Hepatocellular Carcinoma Patients after Hepatic Resection

Effective therapeutic options for elderly patients with hepatocellular carcinoma

Microwave ablation of hepatocellular carcinomas in octogenarians

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