Objective: To estimate the effectiveness of hepatic resection on hepatocellular carcinoma (HCC) in the elderly.
Design: Comparison with younger patients.
Setting: A municipal hospital and a large university hospital in Japan.
Patients: 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).
Main outcome measures: Morbidity and survival following operation and the pathological features of HCC.
Results: 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.
Conclusion: The outcome of surgical treatment of HCC in the elderly group was satisfactory when compared with that in the younger group.