机构地区:[1]Unit of Hepato-Pancreatic-Biliary Surgery,“F.Miulli”Regional General Hospital,Acquaviva Delle Fonti 70021,Italy [2]Interventional Radiology Unit,Department of Radiology,“F.Miulli”Regional General Hospital,Acquaviva Delle Fonti 75100,Italy [3]Hepatobiliary Surgery Division,IRCSS San Raffaele Scientific Institute,Milan 20132,Italy [4]Hepatobiliary Surgery Division,Vita-Salute San Raffaele University,Milan 20132,Italy [5]Département de Chirurgie Viscérale,Gustave Roussy Cancer Campus Grand Paris,Paris 94800,France [6]Unit of Oncologic and Pancreatic Surgery,Hospital University Reina Sofía,Cordoba 14004,Spain [7]Department of Digestive and Hepatobiliary Surgery,Assistance Publique-Hôpitaux de Paris,Créteil 94000,France [8]Service of Abdominal Surgery,Poliambulanza Foundation,Brescia 25124,Italy [9]Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit,University of Modena and Reggio Emilia,Modena 41121,Italy [10]Department of Surgery,Institut de Recherche Contre les Cancers de l'Appareil Digestif(IRCAD),Strasbourg 67000,France [11]Service de Chirurgie Viscérale et Digestive,Nouvel Hôpital Civil,UnitéINSERM U1110,Strasbourg 67000,France [12]Department of Surgery,Hôpital Robert Debré,Reims 51092,France [13]Assistance Publique-Hôpitaux de Paris,Centre Hospitalier Universitaire Henri Mondor,Paris 94000,France [14]Unit of Hepatobiliary Surgery and Liver Transplantation,Hospital University Reina Sofía,Cordoba 14004,Spain [15]Interventional Radiology Unit,Niguarda Hospital,Milan 20162,Italy [16]Department of Surgery,Centre Hepatobiliaire,Hopital Paul Brousse,Paris 94000,France
出 处:《World Journal of Hepatology》2023年第12期1307-1314,共8页世界肝病学杂志(英文版)(电子版)
摘 要: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 sixmonth 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.
关 键 词:Hepatocellular carcinoma SCORE LAPAROSCOPY Surgical resection Elderly patients Multivariate analysis
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