title: Hepatic resection for malignant liver tumours in the elderly: a systematic review and meta-analysis.
abstract: BACKGROUND
  The number of elderly patients undergoing hepatic resection for surgical treatment of benign and malignant cancers is increasing. However, there is limited clinical data on the complications and long-term survival rates associated with liver surgery in the elderly patients (≥70 years) versus younger patients for malignant liver conditions.
  
  
  METHODS
  Six electronic databases were searched for original published studies comparing elderly (≥70) versus younger (<70) cohorts for malignant liver tumours. Data were extracted and analysed according to predefined clinical endpoints.
  
  
  RESULTS
  Twenty-seven comparative studies were identified, including 4769 elderly patients versus 15,855 younger patients (n = 20,624). There was significantly higher 30-day mortality in the elderly colorectal liver metastasis group (P < 0.00002) and significant difference between elderly and young in terms of overall survival (hazard ration (HR), 1.10; P = 0.02). However, there was no difference in disease-free survival (HR, 1.05; P = 0.27). Post-operative pneumonia, renal failure and infection were more frequent in the elderly group.
  
  
  CONCLUSIONS
  Liver resection for malignant hepatic tumours in the elderly is associated with a greater 30-day mortality and overall mortality when compared with younger cohorts, but similar disease-free survival. Length of stay and transfusions were not significantly different while pneumonia, renal failure and infections were more frequent in the elderly group.
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.|St Vincent's Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Phan
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Vincent Vinh Gia
authors.initials: VV
authors.lastname: An
authors.affiliation: St Vincent's Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Hakeem
authors.initials: H
authors.lastname: Ha
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Steven
authors.initials: S
authors.lastname: Phan
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lam
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Pleass
mesh_terms: D000367:Age Factors; D000368:Aged; D018572:Disease-Free Survival; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D015233:Models, Statistical
keywords: elderly; hepatectomy; liver resection; malignant liver disease