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- Title
Liver Resection of Colorectal Liver Metastases in Elderly Patients.
- Authors
Kulik, U.; Framke, T.; Großhennig, A.; Ceylan, A.; Bektas, H.; Klempnauer, J.; Lehner, F.
- Abstract
Background: The percentage of elderly patients with colorectal liver metastases (CLM) has increased. Liver resection remains the only curative therapy; data evaluating the outcome in this age group is limited. Aim of the present study was to determine if postoperative morbidity, mortality, and other independent predictors influence survival in patients ≥70 years undergoing liver resection for CLM. Methods: Clinical data on primary tumor and metastases of 939 patients after liver resection for CLM between 1994 and 2008 were retrospectively collected and subdivided in three age-groups (≥70, 40-69, <40). Independent predictors of survival were evaluated with overall and age-specific univariate and multivariate Cox regression models. Results: A total of 939 patients underwent liver resection for CLM, 20.3% aged ≥70 years. Overall postoperative mortality and morbidity were 1.08 and 14.82%, revealing no age-related differences. With 5-year survival of 31.8% in the elderly and 37.5% in the mid-age population, age ≥70 years was linked with decreased survival (Hazard Ratio [HR] = 1.305; P = 0.0186). Multivariate overall analyses showed size of CLM > 50 mm (HR = 1.376; P = 0.0060), a high amount of transfusion during surgery (HR = 1.676; P = 0.0110), duration of surgery >210 min (HR = 1.241; P = 0.0322), primary UICC (International Union Against Cancer) stage IV (HR = 2.297; P < 0.0001), and performance of repeat resections (HR = 0.652; P = 0.0107) as independent predictors of survival. In the elderly group, effects of UICC IV (HR = 3.260; P = 0.0148) and high numbers of transfusions (HR = 3.647; P = 0.0129) were confirmed; the others did not show statistical significance. Conclusions: Resection of CLM at older age is feasible with morbidity and mortality rates similar to those in younger patients. Although age ≥70 was shown to be associated with poorer overall outcome, reasonable 5-year survival was observed.
- Subjects
LIVER metastasis; LIVER surgery; COLON cancer; OLDER patients; POSTOPERATIVE period; MORTALITY; CANCER; THERAPEUTICS
- Publication
World Journal of Surgery, 2011, Vol 35, Issue 9, p2063
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-011-1180-x