Elderly and very elderly patients with hepatocellular carcinoma. Strategy for a first line treatment

Article Sidebar

PDF
Published: Mar 1, 2014
Keywords:
Elderly and very elderly patients, First line treatments, Hepatocellular carcinoma

Main Article Content

Stefania Brozzetti
Department of Surgery “P. Valdoni”, “Sapienza” University of Rome Medical School, Rome, Italy
Mario Bezzi
Department of Radiology, “Sapienza” University of Rome Medical School, Rome, Italy
Giuseppe Maria De Sanctis
Department of Infectious and Tropical Disease, “Sapienza” University of Rome Medical School, Rome, Italy
Gian Marco Andreoli
Department of Radiology, “Sapienza” University of Rome Medical School, Rome, Italy
Monica De Angelis
Department of Surgery “P. Valdoni”, “Sapienza” University of Rome Medical School, Rome, Italy
Michelangelo Miccini
Department of Surgery “P. Valdoni”, “Sapienza” University of Rome Medical School, Rome, Italy
Francesca Galati
Department of Radiology, “Sapienza” University of Rome Medical School, Rome, Italy
Valentina Panetta
L’altrastatistica s.r.l., Consultancy & Training, Biostatistics office, Rome, Italy
Caterina Furlan
Department of Infectious and Tropical Disease, “Sapienza” University of Rome Medical School, Rome, Italy
Domenico De Santis
Department of Surgery “P. Valdoni”, “Sapienza” University of Rome Medical School, Rome, Italy
Giorgio De Toma
Department of Surgery “P. Valdoni”, “Sapienza” University of Rome Medical School, Rome, Italy
Adriano Tocchi
*Department of Surgery “P. Valdoni”, “Sapienza” University of Rome Medical School, Rome, Italy

Abstract

AIM: Health-status of elderly patients with hepatocellular carcinoma (HCC) may limit surgical approach; other options are thus auspicable.


METHODS: The authors reviewed 98 selected patients, aged 65 to 90 years, with 149 HCC treated between 2002 and 2011. According to the extent of malignancy, health status and treatment, patients were divided into 3 groups. Sixty-one, submitted to major and minor curative resections, were in group A and B while group C included 37 patients, unsuitable for high-risk procedures and percutaneous ablation, submitted to intraoperative-radiofrequency ablation (IRFA) alone or combined with minor resections. Assessment of safety and therapeutic efficacy of this managment was evaluated.


RESULTS: A postoperative mortality rate of 1,02% and an overall survival rate at 5 years of 62.3% were observed. Indeeed matched post-operative morbidity and mortality rates of A, B, C groups were 45%, 8%, 16.21% (p < 0.004) and 9 %, 0%, 0% (p= 0.112 ) respectively. 3 years overall-survival was not statistically different (p= 0.585). However 5 years survival rate and disease-free-survival rate were significantly higher in patients of group A and B (p= 0.003; p< 0.001).


CONCLUSION: Treatment strategies to minimize treatment-related morbidity and mortality have resulted satisfactory for early and late outcomes of an heterogeneous group of elderly patients with HCC.

Article Details

How to Cite
Brozzetti, Stefania, et al. “Elderly and Very Elderly Patients With Hepatocellular Carcinoma. Strategy for a First Line Treatment”. Annali Italiani Di Chirurgia, vol. 85, no. 2, Mar. 2014, pp. 120-8, https://annaliitalianidichirurgia.it/index.php/aic/article/view/1398.
Issue
Vol. 85 No. 2 (2014)
Section
Article