Liver resection of colorectal metastases in elderly patients.
BACKGROUND
This study evaluated the outcome of liver surgery for colorectal metastases (CLM) in patients over 70 years old in a large international multicentre cohort.


METHODS
Among 7764 patients who had resection of CLM, 999 (12.9 per cent) were aged 70-75 years, 468 (6.0 per cent) were aged 75-80 years and 157 (2.0 per cent) were at least 80 years old. Elderly patients were compared with the younger population.


RESULTS
Multinodular and bilateral metastases were less common in elderly than in younger patients (P < 0.001). Preoperative chemotherapy was used less frequently and more limited surgery was performed (P < 0.001). Sixty-day postoperative mortality and morbidity rates were 3.8 and 32.3 per cent respectively, compared with 1.6 and 28.7 per cent in younger patients (both P < 0.001). Three-year overall survival was 57.1 per cent in elderly and 60.2 per cent in younger patients (P < 0.001), and was similar among patients aged 70-75, 75-80 or at least 80 years (57.8, 55.3 and 54.1 per cent respectively; P = 0.160). Independent predictors of survival were more than three metastases, bilateral metastases, concomitant extrahepatic disease and no postoperative chemotherapy.


CONCLUSIONS
Liver resection for CLM in elderly patients can achieve a reasonable 3-year survival rate, with an acceptable morbidity rate. There should be no upper age limit but risk factors may help predict potential benefit.
Adam
R
R
Hepatobiliary Centre, Assistance Publique-Hôpitaux de Paris Hôpital Paul Brousse, University Paris-Sud, Unité Mixte de Recherche S 776, France. rene.adam@pbr.aphp.fr
Frilling
A
A
Elias
D
D
Laurent
C
C
Ramos
E
E
Capussotti
L
L
Poston
G J
GJ
Wicherts
D A
DA
de Haas
R J
RJ
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015179:Colorectal Neoplasms; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D007430:Intraoperative Care; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents