Operative morbidity and survival following hepatectomy for colorectal liver metastasis in octogenarians: a contemporary case matched series.

Published

Journal Article

BACKGROUND: Clinical outcomes of octogenarians undergoing hepatectomy for colorectal liver metastases (CRLM) are poorly characterized. The current study evaluated operative morbidity, mortality and survival outcomes among a contemporary cohort of octogenarians. METHODS: Patients undergoing their first hepatectomy for CRLM were identified from institutional databases and those ≥80 years old (y) were matched 1:1 to a group of patients <80 y. Data pertaining to surgical morbidity/mortality and survival were compared using standard statistical methods. RESULTS: From 2002 to 2012, 1391 hepatectomies were performed for CRLM, 55 (4%) in patients ≥80 y. Major complications occurred twice as frequently among patients ≥80 y [10 (19%) ≥80 y versus 5 (9%) <80 y, (p = 0.270)]. No matched patient <80 y. died within 90 d of operation, whereas, 4 (7%) patients ≥80 y did, p = 0.125. Median follow-up was significantly longer for the <80 y group [44 (1-146) versus. 23 (0-102) mths, p = 0.006]. Probability of disease recurrence was not different between groups (p = 0.123) nor was the cumulative incidence of death from disease (p = 0.371). However, patients ≥80 y had significantly higher incidence of non-cancer related death (p = 0.012). CONCLUSIONS: Hepatectomy for CRLM among well-selected octogenarians is reasonable with cancer related survival outcomes similar to those observed in younger patients. However, it is associated with clinically significant morbidity/mortality and continued efforts directed at optimizing perioperative care are necessary to improve early outcomes among octogenarians.

Full Text

Duke Authors

Cited Authors

  • Leal, JN; Sadot, E; Gonen, M; Lichtman, S; Kingham, TP; Allen, PJ; DeMatteo, RP; Jarnagin, WR; D'Angelica, MI

Published Date

  • February 2017

Published In

Volume / Issue

  • 19 / 2

Start / End Page

  • 162 - 169

PubMed ID

  • 27914765

Pubmed Central ID

  • 27914765

Electronic International Standard Serial Number (EISSN)

  • 1477-2574

Digital Object Identifier (DOI)

  • 10.1016/j.hpb.2016.09.009

Language

  • eng

Conference Location

  • England