Advanced age is not a contraindication for liver resection in cases of large hepatocellular carcinoma

作者：Fan H L; Hsieh C B; Chang W C; Huang S H; Chan D C; Yu J C; Chu C H; Chen T W^*

来源：European Journal of Surgical Oncology, 2014, 40(2): 214-219.

DOI：10.1016/j.ejso.2013.10.016

• Hepatocellular carcinoma
• Liver resection
• Transarterial chemoembolization
• Charlson comorbidity index

Background: The role of surgery in the management of large hepatocellular carcinomas (HCCs) is controversial. Advanced age and comorbidities are taken into account when major surgery is considered.
Purpose: To compare the outcomes of liver resection (LR) and transarterial chemoembolization (TACE) for resectable HCC in patients aged 70 years or older.
Patients and materials: This study included 70 patients aged 70 years or older treated for large HCCs (>= 5 cm) between January 2007 and December 2012: 37 underwent LR and 33 underwent TACE. The outcomes of these patients were retrospectively analyzed. Univariate and multivariate Cox proportional hazard models were established. Kaplan-Meier survival curves were generated; and survival data were compared using the log-rank test.
Results: Hospital stay was significantly longer in the LR group than in the TACE group (10 days vs 8.5 days; P = 0.003). Treatment-related complications were more frequent in the TACE group, but this difference was not statistically significant. LR was associated with a better disease-free survival rate, median survival rate and cumulative overall survival rate.
Conclusion: Our results showed that LR could be a safe and effective treatment option for HCC tumors >5 cm in patiets aged 70 years or older.

• 出版日期2014-2