Long-term oncologic prognosis after hepatectomy for hepatocellular carcinoma: Differences between the young (≤ 35 years old) and the elderly (≥ 70 years old)

Jia Le Pu, Zhong Chen, Lan Qing Yao, Ji Ye Feng, Yong Kang Diao, Feng Shen, Timothy M. Pawlik, Wan Yee Lau, Tian Yang

Research output: Contribution to journalArticlepeer-review

Abstract

Background: While hepatocellular carcinoma (HCC) is the most common malignancy in the elderly worldwide, it is also common among younger individuals in areas with endemic hepatitis B virus infection. The characterized differences in long-term oncological prognosis among young versus elderly patients after R0 liver resection for HCC were sought in this study. Methods: Using a Chinese multicentre database, consecutive patients who underwent R0 liver resection for HCC between 2007 and 2019 were retrospectively analysed. After excluding middle-aged (36–69 years old) patients, overall survival (OS), cancer-specific survival (CSS), and time-to-recurrence (TTR) were compared between young (≤ 35 years old) versus elderly (≥ 70 years old) patients using propensity score matching (PSM). Results: Among 531 enrolled patients, there were 192 (36.2%) and 339 (63.8%) patients categorized as young versus elderly, respectively. PSM analysis created 140 pairs of matched patients. In the PSM cohort, 5-year OS was comparable among young versus elderly patients (51.7% vs. 52.3%, p = 0.533). Young patients did, however, had a higher 5-year TTR (62.1% vs. 51.6%, p = 0.011) and a worse 5-year CSS (54.0% vs. 64.3%, p = 0.034) than elderly patients. On multivariable Cox-regression analyses, young patient age remained independently associated with an increased TTR rate (HR 1.62, p = 0.016) and a decreased CSS rate (HR 1.69, p = 0.021) compared with elderly patients. Conclusions: Following R0 liver resection for HCC, younger patients were at a higher risk of recurrence, yet elderly patients had a better CSS rate. Thus, enhanced surveillance for HCC recurrence should be implemented for young patients.

Original languageEnglish
Pages (from-to)S305
JournalAnnals of Hepato-Biliary-Pancreatic Surgery
Volume26
DOIs
StatePublished - 2022
Externally publishedYes

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