title: The Impact of Advancing Age on Recurrence and Survival Following Major Hepatectomy for Colorectal Liver Metastases.
abstract: This study analysed the effect of age on survival in patients undergoing major hepatectomy (MH) for colorectal liver metastases (CRLM). The effect of adjuvant chemotherapy (AC) with age was also assessed.
  
  
  
  Patients undergoing MH for CRLM between 1996 and 2011 were reviewed. Patients aged <75 or ≥75 were compared for disease-free (DFS) and overall survival (OS) as well as impact of AC on survival.
  
  
  
  Seven hundred twenty-seven patients underwent MH of which 105 (14 %) were aged ≥75. Morbidity was greater in the ≥75 group (25 versus 34 %, p = 0.048). No difference was noted in mortality. There was no difference in DFS between the two groups at 5 years (16.8 vs 18.9 months (p = 0.570). OS was longer in the <75 group (38.6 vs 32.0 months (p = 0.001). DFS was better in groups receiving AC than those not (<75 24.2 vs 12.2 months (p = <0.001) and ≥75 24 vs 12.1 months (p = 0.007)). OS in the ≥75 group was improved in the group receiving AC compared to the ≥75 group not (41.1 vs 16.6 months, p = 0.005). Age ≥75 was not an independent risk factor for reduced DFS on multivariate analysis.
  
  
  
  Well-selected patients aged ≥75 should be considered for MH followed by adjuvant chemotherapy.
authors: Department of Hepatobiliary and Transplant Surgery, St James University Hospital, ICU Offices, Level 3 Bexley Wing, Leeds, LS9 7TF, UK. richard.bell@doctors.org.uk.
authors: Richard
authors: R
authors: Bell
authors: Department of Hepatobiliary Surgery, Auckland City Hospital, Auckland, New Zealand.|Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors: Sanjay
authors: S
authors: Pandanaboyana
authors: Department of Hepatobiliary and Transplant Surgery, St James University Hospital, ICU Offices, Level 3 Bexley Wing, Leeds, LS9 7TF, UK.
authors: Saira
authors: S
authors: Nisar
authors: Department of Hepatobiliary and Transplant Surgery, St James University Hospital, ICU Offices, Level 3 Bexley Wing, Leeds, LS9 7TF, UK.
authors: Vivek
authors: V
authors: Upasani
authors: Department of Hepatobiliary and Transplant Surgery, St James University Hospital, ICU Offices, Level 3 Bexley Wing, Leeds, LS9 7TF, UK.
authors: Giles
authors: G
authors: Toogood
authors: Department of Hepatobiliary and Transplant Surgery, St James University Hospital, ICU Offices, Level 3 Bexley Wing, Leeds, LS9 7TF, UK.
authors: J Peter
authors: JP
authors: Lodge
authors: Department of Hepatobiliary and Transplant Surgery, St James University Hospital, ICU Offices, Level 3 Bexley Wing, Leeds, LS9 7TF, UK.
authors: K Raj
authors: KR
authors: Prasad
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000401:mortality; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents
keywords: Age; Colorectal liver metastases; Elderly; Major hepatectomy