Outcome analysis for patients with early- and late-onset primary liver carcinomas. A StuDoQ data analysis

Background and aim: Liver resection is a common treatment for both early- and late-onset primary liver carcinomas. Postoperative outcomes, however, depend on factors like comorbidities, perioperative complications, histology, and resection extent. The present study investigates the impact of these factors, focusing on the comparison of early- versus late-onset carcinomas.

Methods: Retrospective analysis of the StuDoQ Database focused on 1,418 patients, including 721 (50.8%) cases with HCC and 697 (49.2%) with CCC histology. Patients were divided into three age groups: Young (≤55 years, n=442 (31.2%)), middle-aged (55-70 years, n=601 (42.4%)), and elder patients (>70 years, n=375 (26.4%)). Missing data were imputed using a deep learning algorithm. The comparison focused on preoperative lab values, ECOG, comorbidities, and perioperative factors such as surgery technique and time. Outcome variables included postoperative ECOG, Clavien-Dindo, hospitalization, complications, and mortality. Group differences were tested using Chi-squared for categorial and Kruskal-Wallis, Mann-Whitney U, or t-test for continuous variables, depending on data normality.

Results: Most preoperative parameters showed no significant age-related differences. However, older patients had significantly (p≤0.05) higher ASA scores (≥3: 67.8% old vs. 44.6% young), alcohol consumption (7.7% vs. 3.4%), and cirrhosis (8.8% vs. 2.5%). Overall, surgical approaches were chosen age-independent, whereas CCC more often required two-stage, open surgery, and longer surgery times. Perioperative parameters and histology had the strongest influence on outcomes, while significant age effects were limited to postoperative ECOG and weight loss. CCC patients showed significantly higher rates of major complications (Clavien≥3a: 34.6% vs. 21.4% for HCC), longer hospitalization (median: 14 vs. 9 days), higher readmission (11.6% vs. 8.0%), and reoperation rates (15.4% vs. 7.6%). Interestingly, the age group most affected by complications varied by histology: Early postoperative Clavien complication peaks were seen in younger HCC but middle-aged CCC patients, with a reversed pattern at 90-day follow-up.

Conclusion: In summary, perioperative parameters and histology emerged as the strongest predictors of postoperative outcomes after liver resection, whereas age-related effects were less pronounced. These insights may enhance individualized and age-dependent surgical planning and risk management ([Fig. 1]).

Fig. 1  

Quelle: Dr. C. V. Frost; generiert mit Python Matplotlib und ChatGPT

Publikationsverlauf

Artikel online veröffentlicht:
04. September 2025