Author:
Conticchio Maria,Inchingolo Riccardo,Delvecchio Antonella,Ratti Francesca,Gelli Maximiliano,Anelli Massimiliano Ferdinando,Laurent Alexis,Vitali Giulio Cesare,Magistri Paolo,Assirati Giacomo,Felli Emanuele,Wakabayashi Taiga,Pessaux Patrick,Piardi Tullio,di Benedetto Fabrizio,de'Angelis Nicola,Briceño Javier,Rampoldi Antonio,Adam Renè,Cherqui Daniel,Aldrighetti Luca Antonio,Memeo Riccardo
Abstract
BACKGROUND
Liver resection is the mainstay for a curative treatment for patients with resectable hepatocellular carcinoma (HCC), also in elderly population. Despite this, the evaluation of patient condition, liver function and extent of disease remains a demanding process with the aim to reduce postoperative morbidity and mortality.
AIM
To identify new perioperative risk factors that could be associated with higher 90- and 180-d mortality in elderly patients eligible for liver resection for HCC considering traditional perioperative risk scores and to develop a risk score.
METHODS
A multicentric, retrospective study was performed by reviewing the medical records of patients aged 70 years or older who electively underwent liver resection for HCC; several independent variables correlated with death from all causes at 90 and 180 d were studied. The coefficients of Cox regression proportional-hazards model for six-month mortality were rounded to the nearest integer to assign risk factors' weights and derive the scoring algorithm.
RESULTS
Multivariate analysis found variables (American Society of Anesthesiology score, high rate of comorbidities, Mayo end stage liver disease score and size of biggest lesion) that had independent correlations with increased 90- and 180-d mortality. A clinical risk score was developed with survival profiles.
CONCLUSION
This score can aid in stratifying this population in order to assess who can benefit from surgical treatment in terms of postoperative mortality.
Publisher
Baishideng Publishing Group Inc.