Perioperative factors related to the prognosis of elderly patients with hepatocellular carcinoma

Abstract

Background Hepatic resection is a potentially curative treatment for patients with hepatocellular carcinoma (HCC). The treatment of elderly patients with HCC has always been difficult. With the development of geriatrics and geriatric surgery, the number of elderly patients with HCC undergoing hepatectomy has gradually increased. To further improve the long-term prognosis of elderly patients with hepatocellular carcinoma undergoing surgery, it is necessary to study the related perioperative factors. Our aim was to study the impact of preoperative and intraoperative factors on the long-term survival of elderly patients with HCC who underwent hepatectomy. Methods A total of 151 elderly patients with HCC who underwent hepatectomy were retrospectively studied. Univariate and multivariate Cox regression analyses were performed for preoperative- and intraoperative-related prognostic factors. Results The 1-, 3-, 5- and 10-year overall survival rates of elderly patients with HCC who underwent resection were 79.5%, 60.8%, 46.6%, and 25.4%, respectively. Multivariate analyses identified four independent predictors of long-term prognosis: Child–Pugh grade (B/C versus A: HR[hazard ratio] = 2.318, P = 0.019), alpha-fetoprotein value (> 20 ng/ml versus ≤ 20 ng/ml: HR = 1.972, P = 0.005), resection style (anatomical versus no anatomical: HR = 1.976, P = 0.006), and intraoperative blood loss (> 400 ml versus ≤ 400 ml: HR = 2.008, P = 0.003). Conclusions Poor survival of elderly patients with HCC who underwent hepatectomy was correlated with the preoperative and intraoperative factors of Child–Pugh grade, Alpha-fetoprotein value, resection style, and intraoperative blood loss.

Development of an individualized model for predicting postoperative delirium in elderly patients with hepatocellular carcinoma

“…Mingfang Yan 1,5 , Zhaoyan Lin 2,5 , Huizhe Zheng 1 , Jinglan Lai 3 Hepatocellular carcinoma (HCC) ranks as the sixth most commonly diagnosed cancer and the third deadliest globally 1 . Globally, the incidence rates of HCC exhibit a positive correlation with age, reaching their peak around the age of 75 years 2,3 . Owing to rapid aging of the global population and a record-high average life expectancy, there is a growing incidence of older patients diagnosed with HCC 4,5 .…”