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TITLE:

CLINICAL ANALYSIS OF HEPATOCELLULAR CARCINOMA AFTER HEPATIC RESECTION IN YOUNGER VERSUS ELDERLY PATIENTS

AUTHORS:

Waseem Sami Malik, Wang Hai Jiu, Fan Hai Ning, Wang Zhi Xin, Muhammad Ali, Ren Li

ABSTRACT:

Objectives: Analyze the clinical preoperative laboratory data, intraoperative findings, and surgical outcome of HCC in older v/s younger patients those who underwent surgical resection. Methods: A total of 51 “elderly” (≥65 years old) and 102 “younger” (≤65 years old) who underwent hepatic resection between January 2013 to February 2020 were identified and included in this study. Demographic and operative data, pathological findings, and postoperative outcomes were collected. Prognostic factors were analyzed by univariate and multivariate analysis. Results: In both of groups, younger males (91.17%) and older female (23.6%) with a combined P-value <0.004, have a higher proportion of HCC. More underlying Hepatitis B virus infection and cirrhosis found in younger (84.4% - 94.1%). More underlying diabetes mellitus and Hepatitis C were observed in elderly HCC. There was no significant statistical difference in the Child-Pugh class in both groups. The intraoperative parameters younger patients received right-sided hepatectomy, right hepatectomy (65.7%), and right trisegmentomy (10.8%) while the older patients mostly received left-sided hepatectomy, left hepatectomy (37.3%). Post-operative pneumonia and pleural effusion common in younger group (9.8%,P<0.514 and 34.5%,P<0.312 respectively), while wound infections were most commonly seen in the elderly (19.6%, P<0.530). The overall estimated mortality and hospitalization were not significantly different in both groups. Conclusion: Two groups of operative outcomes indicated that the right lobe of liver HCC more in the younger and left lobe more in older patients and post-operative wound infection in elderly and pleural effusion. Still, it proves that a hepatic resection is a safe option in Hepatocellular carcinoma. Keywords: hepatocellular carcinoma, wound infection, hepatectomy.

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