Journal article
Outcomes in elderly patients undergoing hepatic resection compared to ablative therapy for hepatocellular carcinoma
Journal of surgical oncology, Vol.128(5), pp.803-811
10/01/2023
DOI: 10.1002/jso.27369
PMID: 37288805
Abstract
Background and ObjectivesHepatic resection is an excellent option in the care of patients with hepatocellular carcinoma (HCC). Elderly patients often forego hepatic resection in favor of liver-directed ablative therapies due to the increased likelihood of adverse postoperative outcomes due to age. We sought to determine long-term outcomes in patients who underwent hepatic resection compared to liver-directed ablative therapy in this patient population. MethodsWe queried the National Cancer Database for elderly patients (>= 70 years) diagnosed with HCC between 2004 and 2018. The primary outcome was overall survival (OS) computed using the Kaplan-Meier method and Cox proportional hazard regression. ResultsA total of 10 032 patients were included in this analysis. On unadjusted analysis (p < 0.001) as well as multivariable analysis (hazard ratio: 0.65, 95% confidence interval: 0.57-0.73), hepatic resection was associated with improved OS. The protective association between hepatic resection and OS persisted after 1:1 propensity score matching. ConclusionsHepatic resection is associated with improved survival for well-selected elderly patients with HCC. While age is often thought of as influencing the decision to offer surgery, our study, in combination with others, demonstrates that it should not. Instead, other objective indicators of performance and functional status may be considered.
Details
- Title: Subtitle
- Outcomes in elderly patients undergoing hepatic resection compared to ablative therapy for hepatocellular carcinoma
- Creators
- Fasih A. Ahmed - University Hospitals of ClevelandSameer A. Khan - University of Pennsylvania Health SystemMuhammad S. Hafeez - University of Pittsburgh Medical CenterFaisal S. Jehan - Westchester Medical CenterHassan Aziz - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Journal of surgical oncology, Vol.128(5), pp.803-811
- DOI
- 10.1002/jso.27369
- PMID
- 37288805
- NLM abbreviation
- J Surg Oncol
- ISSN
- 0022-4790
- eISSN
- 1096-9098
- Publisher
- Wiley
- Number of pages
- 9
- Language
- English
- Date published
- 10/01/2023
- Academic Unit
- Surgery
- Record Identifier
- 9984701644002771
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