title: Hepatic resection for malignancy in the elderly.
abstract: Although elderly patients are accounted for in all large series of major hepatic resections, the role of age as a determinant of outcome remains unclear. At Cedars-Sinai Medical Center, we review a series of 20 major hepatectomies for neoplasia performed in patients older than 66 years of age (4 of them > or = 80 years old) over a 5-year period. A retrospective comparison was conducted with a group of 22 hepatectomies for malignancy performed in 20 patients younger than 59 years of age during the same time period. The younger group had a significantly greater degree of liver resected (12 trisegmentectomies vs 3). Although one operative death (5% mortality) was observed in the elderly group, no statistically significant difference was noted, when compared to the younger group (Chi-square, P = 0.48). Likewise, no significant difference in the complication rate (20% vs 33%) was noticed (Chi-square, P = 0.8). Severe postoperative liver dysfunction was present in 2 cases (10%) in the elderly group and one (4%) in the younger group. These patients underwent a right trisegmentectomy (TS). Nine patients from each group were resected without red blood cell transfusion. We conclude that major hepatic resection in elderly patients without severe comorbid disease is a safe procedure that is not associated with an increased perioperative morbidity or mortality rate.
authors.affiliation: Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Cosenza
authors.forename: A L
authors.initials: AL
authors.lastname: Hoffman
authors.forename: L G
authors.initials: LG
authors.lastname: Podesta
authors.forename: L
authors.initials: L
authors.lastname: Sher
authors.forename: R R
authors.initials: RR
authors.lastname: Lopez
authors.forename: D
authors.initials: D
authors.lastname: Lugo
authors.forename: L
authors.initials: L
authors.lastname: Makowka
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016019:Survival Analysis