Journal article
Outcomes in elderly patients undergoing hepatic resection compared to liver transplant for hepatocellular carcinoma
Journal of surgical oncology, Vol.128(8), pp.1320-1328
12/01/2023
DOI: 10.1002/jso.27430
PMID: 37638401
Appears in UI Libraries Support Open Access
Abstract
Background: Hepatic resection (HR) is an excellent option for patients with hepatocellular carcinoma (HCC). For patients meeting the Milan criteria, a liver transplant (LT) is also a viable option for patients with HCC, especially those with end-stage liver disease. With increasing rates of LTs amongst the elderly, we sought to determine long-term outcomes in patients who underwent HR compared to LTs in this patient population.
Methods: We queried the national cancer database for elderly patients (>= 70 years) diagnosed with HCC between 2004 and 2020. The primary outcome was overall survival (OS) computed using the Kaplan-Meier method and Cox proportional hazard regression. One-to-one propensity score matching was conducted on the basis of clinicodemographic features to account for baseline differences between patients undergoing each procedure.
Results: Of the 5090 patients included, 4674 (91.8%) and 416 (8.2%) patients underwent HR and LT, respectively. Compared with HR patients, patients receiving LT had better OS (p<0.001) and greater median survival time (65.6 months HR vs. 97.9 months LT, p<0.001). On multivariable analysis, a LT was independently associated with improved survival (adjusted hazard ratio: 0.61, 95% confidence interval: 0.50-0.76, p<0.001).
Conclusions: LT is associated with improved survival for well-selected elderly patients with HCC. Age alone should not be used as the sole parameter for the candidacy of LT in elderly patients.
Details
- Title: Subtitle
- Outcomes in elderly patients undergoing hepatic resection compared to liver transplant for hepatocellular carcinoma
- Creators
- Sameer A. Khan - University of Pennsylvania Health SystemFasih A. Ahmed - University of Pennsylvania Health SystemMuhammad S. Hafeez - Henry Ford HospitalLawrence R. Feng - Iowa Carver Coll Med, Iowa City, IA USAAbhinav Seth - Iowa Carver Coll Med, Iowa City, IA USAYong K. Kwon - University of WashingtonHassan Aziz - Iowa Carver Coll Med, Iowa City, IA USA
- Resource Type
- Journal article
- Publication Details
- Journal of surgical oncology, Vol.128(8), pp.1320-1328
- DOI
- 10.1002/jso.27430
- PMID
- 37638401
- NLM abbreviation
- J Surg Oncol
- ISSN
- 0022-4790
- eISSN
- 1096-9098
- Publisher
- Wiley
- Number of pages
- 9
- Language
- English
- Date published
- 12/01/2023
- Academic Unit
- Surgery
- Record Identifier
- 9984701649702771
Metrics
6 Record Views