Major liver resections in the elderly-is an aggressive approach justified?
OBJECTIVE
As the mean life expectancy rises, the incidence of patients 75 years of age and older who present with colorectal liver metastases continues to increase. The purpose of our study was to evaluate the outcome of major hepatic resections in the elderly population.


METHODS
From April 1998 to December 2006, 572 consecutive patients with colorectal liver metastases were treated at our Institution. Of these, 59 were 75 years or older. There was an intent to proceed with major liver resections in all cases. Data were analyzed according to diagnosis, comorbidities, extent of liver resection, postoperative complications, overall survival, and disease-free survival.


RESULTS
Surgical treatment included right hepatectomies (n = 8), left hepatectomies (n = 4), and sectionectomies (more than three segments; n = 33). Fourteen (n = 14) patients received an explorative laparotomy alone. Morbidity and hospital mortality were 10% and 3%, respectively. Overall survival of 1, 3, and 5 years was 90%, 64%, and 33%, respectively. The corresponding disease-free survival was 74%, 42%, and 32%. Resection margin (R class) was the only predictor of survival by both uni- and multivariate analyses.


CONCLUSIONS
Hepatic resections can be performed safely in selected patients 75 years of age or older.
Bockhorn
Maximilian
M
Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. m.bockhorn@uke.uni-hamburg.de
Sotiropoulos
Georgios C
GC
Sgourakis
George
G
Neuhaus
Jan P
JP
Molmenti
Ernesto P
EP
Lang
Hauke
H
Frilling
Andreja
A
Broelsch
Christoph E
CE