Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma: A multicenter analysis with propensity score matching

2019 ◽  
Vol 50 (1) ◽  
pp. 75-83 ◽  
Author(s):  
Toshifumi Tada ◽  
Takashi Kumada ◽  
Atsushi Hiraoka ◽  
Kojiro Michitaka ◽  
Masanori Atsukawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Safety And Efficacy ◽  
Unresectable Hepatocellular Carcinoma ◽  
Multicenter Analysis

scholarly journals Short-term outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma in elderly patients: A propensity score matching analysis

2020 ◽  
Author(s):  
Kazuteru Monden ◽  
Hiroshi Sadamori ◽  
Masayoshi Hioki ◽  
Satoshi Ohno ◽  
Norihisa Takakura
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Oral Intake ◽  
Short Term ◽  
Open Liver Resection ◽  
Propensity Score Matching Analysis ◽  
Baseline Characteristics

Abstract The number of elderly patients with hepatocellular carcinoma (HCC) requiring surgical treatment has been continuously increasing. This study aimed to examine the safety and feasibility of laparoscopic liver resection (LLR) versus open liver resection (OLR) for HCC in elderly patients at our institution in Japan.Between 2010 and 2018, LLR and OLR were performed in 80 and 138 elderly patients (>70 years) who were diagnosed with HCC, respectively. Propensity score matching (PSM) analysis with covariates of baseline characteristics was applied. Intra- and postoperative data were evaluated in both groups.After PSM, 56 patients who underwent LLR and OLR, respectively, were compared. No significant differences in demographic, clinical data, and operative times were observed. Blood loss (OLR: 327 mL; LLR: 50 mL; P< 0.001), length of postoperative hospital stay (OLR: 12 days; LLR: 7 days; P< 0.001), and time to start oral intake (OLR: 2 days; LLR: 1 day; P< 0.001) were significantly lower and shorter in the LLR group than in the OLR group. The incidence of complications over Clavien-Dindo class IIIa was similar between both groups.Our results suggest that advanced age alone is not a contraindication, and LLR can be a treatment option for elderly patients with HCC.

scholarly journals Short-Term Outcomes of Laparoscopic Versus Open Liver Resection for Hepatocellular Carcinoma in Elderly Patients: A Propensity Score Matching Analysis

2021 ◽  
Author(s):  
Kazuteru Monden ◽  
Hiroshi Sadamori ◽  
Masayoshi Hioki ◽  
Satoshi Ohno ◽  
Norihisa Takakura
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Oral Intake ◽  
Short Term ◽  
Open Liver Resection ◽  
Propensity Score Matching Analysis ◽  
Baseline Characteristics

Abstract BackgroundThe number of elderly patients with hepatocellular carcinoma (HCC) requiring surgical treatment has been continuously increasing. This study aimed to examine the safety and feasibility of laparoscopic liver resection (LLR) versus open liver resection (OLR) for HCC in elderly patients at our institution in Japan.MethodsBetween 2010 and 2018, LLR and OLR were performed in 80 and 138 elderly patients (aged > 70 years) who were diagnosed with HCC, respectively. Propensity score matching (PSM) analysis with covariates of baseline characteristics was applied. Intra- and postoperative data were evaluated in both groups.ResultsAfter PSM, 56 patients who underwent LLR and OLR, respectively, were compared. No significant differences in demographic, clinical data, and operative times were observed. Blood loss (OLR: 327 mL, LLR: 50 mL [P < 0.001]), length of postoperative hospital stay (OLR: 12 days, LLR: 7 days [P < 0.001]), and time to start oral intake (OLR: 2 days, LLR: 1 day [P < 0.001]) were significantly lower and shorter in the LLR group than in the OLR group. The incidence of complications over Clavien-Dindo class IIIa was similar between both groups.ConclusionsOur results suggest that advanced age alone is not a contraindication, and LLR can be a treatment option for elderly patients with HCC.Trial registration: retrospectively registered

Laparoscopic versus Open Hepatectomy for Hepatocellular Carcinoma in Elderly Patients: A Single-Institutional Propensity Score Matching Comparison

2020 ◽  
Vol 37 (6) ◽  
pp. 495-504
Author(s):  
Wethit Dumronggittigule ◽  
Ho-Seong Han ◽  
Soyeon Ahn ◽  
Yoo-Seok Yoon ◽  
Jai Young Cho ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Laparoscopic Hepatectomy ◽  
Perioperative Outcomes ◽  
High Morbidity ◽  
Complication Rates ◽  
High Morbidity Rate ◽  
Open Hepatectomy

<b><i>Background:</i></b> The incidence of hepatocellular carcinoma (HCC) in elderly patients is increasing worldwide. Although open hepatectomy (OH) yields acceptable outcomes, high morbidity rate is concerned. Laparoscopic hepatectomy (LH) has evolved to improve perioperative outcomes. However, comparative study between both techniques for elderly patients with HCC is scarce. <b><i>Objective:</i></b> This study aimed to compare outcomes between LH and OH specifically. <b><i>Methods:</i></b> HCC patients aged ≥70 years after hepatectomy (2003–2018) were included. The propensity score matching (PSM) and comparative analyses between groups were performed. <b><i>Results:</i></b> After PSM, there were 41 patients in each group with similar demographics, radiographic tumor characteristics, cirrhotic status, and extent of resection. The LH group had a shorter hospital stay (7 vs. 11 days, <i>p</i> = 0.002) compared with the OH group. The completeness of resection and complication rates were not statistically different between groups. The 5-year overall survival and recurrence-free survival rates were 86.7 and 43.4% in the LH group and 62.2 and 30.8% in the OH group (<i>p</i> = 0.221 and 0.500). <b><i>Conclusion:</i></b> Our study confirmed the operative and oncological safety of LH in elderly HCC patients with improved perioperative outcomes compared with OH.

The Short- and Long-Term Outcomes in Elderly Patients with Hepatocellular Carcinoma after Curative Surgery: A Case-Controlled Study with Propensity Score Matching

2018 ◽  
Vol 59 (5-6) ◽  
pp. 380-390 ◽  
Author(s):  
Yukiyasu Okamura ◽  
Teiichi Sugiura ◽  
Takaaki Ito ◽  
Yusuke Yamamoto ◽  
Ryo Ashida ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Long Term Outcomes ◽  
Propensity Matching ◽  
Short And Long Term ◽  
Overall Survival Rates

Background: With aging populations increasing in developed countries, the prevalence of elderly patients with hepatocellular carcinoma (HCC) is expected to rise. The aim of this study was to determine the short- and long-term outcomes of HCC surgery in elderly patients (≥75 years) using propensity score matching. Methods: The study group included 421 patients who underwent hepatectomy as their initial treatment with curative intent. The patients were divided into elderly (n = 111) and non-elderly (n = 310) groups. We applied propensity score matching – taking into consideration patient background, blood examination, and tumor factors – to minimize the effect of potential confounders. We then compared the results before and after the propensity matching. Results: Before propensity matching, the elderly group included significantly more patients with a high American Society of Anesthesiologists physical status (p < 0.001). In addition, they were taking antihypertensive drugs or an anticoagulant (both p < 0.001). The severe postoperative complications and the overall survival rates for these elderly patients were significantly poorer than for the non-elderly patients (p = 0.015 and p = 0.030, respectively). We then chose 70 patients from each group for whom the preoperative confounding factors were balanced and compared the two groups. The factors identified before matching (severe complications and overall survival rates) were no longer relevant, i.e. there were no significant differences between the two groups. Conclusion: Hepatectomy for HCC in elderly patients is justified.

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