Major hepatectomy is safe for hepatocellular carcinoma in elderly patients with cirrhosis

Wang, Wanli; Zhu, Ying; Cheng, Jiwen; Li, Muxing; Xia, Jianmin; Hao, Jie; Yu, Liang; Lv, Yi; Wu, Zheng; Wang, Bo

doi:10.1097/meg.0000000000000046

Cited by 24 publications

(20 citation statements)

References 37 publications

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“…As a result of recent advances, liver resection has become a reasonably safe treatment, and aggressive surgical resection has been proposed for cases with advanced disease [30][31][32]. Consequently, the age of patients undergoing liver resection has recently been increasing [33,34]. This situation indicates the emerging need for a formula that includes age in predictions of the SLV [4].…”

Section: Discussionmentioning

confidence: 96%

A new formula for calculating standard liver volume for living donor liver transplantation without using body weight

Kobayashi¹,

Hasegawa²,

Uldry³

et al. 2015

Journal of Hepatology

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Section: Discussionmentioning

confidence: 96%

A new formula for calculating standard liver volume for living donor liver transplantation without using body weight

Kobayashi¹,

Hasegawa²,

Uldry³

et al. 2015

Journal of Hepatology

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“…The operation time, American Society of Anesthesiologists (ASA) physical status classification, blood transfusion and other factors have been reported to contribute to post-operative morbidity (26,27). A score based on age, presence of cardiovascular disease, pulmonary disease and diabetes mellitus, as well as performance status and the ASA score, can be used to predict post-operative morbidity (28).…”

Section: Discussionmentioning

confidence: 99%

Assessing the feasibility of clinicopathological features of hepatic resection for hepatocellular carcinoma in patients over 80 years of age

Iida

Kaibori

Matsui

et al. 2016

Molecular and Clinical Oncology

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The aim of the present study was to evaluate the clinicopathological features, benefits and problems associated with hepatic resection of hepatocellular carcinoma in patients aged ≥80 years. Between 2006 and 2013, hepatic resection was performed in 395 hepatocellular carcinoma patients, including 351 patients aged <80 years and 44 patients aged ≥80 years. Clinicopathological examination revealed that the tumor size was significantly larger among patients of ≥80 years of age. However, recurrence-free and cumulative survival rates were similar between the two age groups. The occurrence of post-operative complications was an independent risk factor for survival among patients ≥80 years of age. In addition, the albumin level was identified as a risk factor for post-operative complications. The post-operative transition towards an improvement in the albumin level in the ≥80 years group was significantly lower compared with the <80 years group. It was revealed that hepatic resection was feasible for elderly patients. However, the post-operative improvement in the albumin levels was less marked among patients ≥80 years of age, and lower albumin levels were associated with post-operative complications and prognosis. Therefore, elderly patients undergoing hepatic resection should receive peri-operative management including special nutrition.

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“…As shown in Table , many recent studies have reported that surgical outcomes among older patients with HCC were comparable with those among younger patients with HCC. For elderly patients with HCC, the mortality rate after hepatectomy ranged from 0 to 42.9% while the morbidity rate ranged from 9 to 51%.…”

Section: Increasing Liver Resection In Elderly Patientsmentioning

confidence: 89%

Mechanism of impairment on liver regeneration in elderly patients: Role of hepatic stellate cell function

Saito

Morine

2017

Hepatology Research

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Japan, along with most other countries in the world, is facing an increasingly aging population with a prolonged life expectancy. Concurrently, the need for medical intervention, including hepatectomy, has also increased for the elderly. Although surgical outcomes for older patients are reported to be comparable with those for younger patients, additional care in the selection of older patients for hepatectomy is considered necessary. Although the effect of aging on human liver regeneration is not fully understood, the regeneration of liver tissue after hepatectomy in elderly patients is shown to be generally worse than in younger patients and, to date, the mechanisms involved in the impairment of liver regeneration have not been fully clarified. Hepatic stellate cells (HSCs) are liver-specific mesenchymal cells that play critical roles in liver physiology and fibrogenesis. Recent studies in liver regeneration have increasingly focused on HSCs rather than on hepatocytes, Kupffer cells, endothelial cells, or infiltrating immune cells and suggest that HSCs might play a critical role in liver regeneration. In this review, we summarize the mechanisms involved in the impairment of liver regeneration in elderly patients, especially focusing on HSCs. We also discuss how HSCs contribute to the impairment of liver regeneration.

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Major hepatectomy is safe for hepatocellular carcinoma in elderly patients with cirrhosis

Cited by 24 publications

References 37 publications

A new formula for calculating standard liver volume for living donor liver transplantation without using body weight

A new formula for calculating standard liver volume for living donor liver transplantation without using body weight

Assessing the feasibility of clinicopathological features of hepatic resection for hepatocellular carcinoma in patients over 80 years of age

Mechanism of impairment on liver regeneration in elderly patients: Role of hepatic stellate cell function

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