OBJECTIVES: To assess the safety and long-term results of hepatic resection of colorectal liver metastases (CLM) in older adults. DESIGN: Case-control. SETTING: Single liver and multivisceral transplant center. PARTICIPANTS: Individuals with CLM: 32 aged 70 and older (older group) and 32 younger than 70 (younger group) matched in a 1:1 ratio according to sex, primary tumor site, liver metastases at diagnosis, number of metastases, maximum tumor size, infiltration of cut margin, type of hepatic resection, and hepatic resection timing. MEASUREMENTS: Postoperative complications and survival rates. RESULTS: There was no significant difference in preoperative clinical findings between the two study groups. The incidence of cumulative postoperative complications was similar in the older (28.1%) and younger (34.4%) groups (P = .10). One-, 3-, and 5-year disease-free survival rates were 57.6%, 32.9%, and 16.4%, respectively, in the younger group and 67.9%, 29.2%, and 19.5%, respectively, in the older group (P = .72). One-, 3-, and 5-year participant survival rates were 84.1%, 51.9%, and 33.3%, respectively, in the older group and 93.6%, 63%, and 28%, respectively, in the younger group (P = .50). CONCLUSIONS: Resection of colorectal liver metastases in older adults can be performed with low mortality and morbidity and offers a long-time survival advantage to many of these individuals. Based on the results of this case-control study, older adults should be considered for surgical treatment whenever possible.
OBJECTIVES: To assess the safety and long-term results of hepatic resection of colorectal liver metastases (CLM) in older adults. DESIGN: Case-control. SETTING: Single liver and multivisceral transplant center. PARTICIPANTS: Individuals with CLM: 32 aged 70 and older (older group) and 32 younger than 70 (younger group) matched in a 1:1 ratio according to sex, primary tumor site, liver metastases at diagnosis, number of metastases, maximum tumor size, infiltration of cut margin, type of hepatic resection, and hepatic resection timing. MEASUREMENTS: Postoperative complications and survival rates. RESULTS: There was no significant difference in preoperative clinical findings between the two study groups. The incidence of cumulative postoperative complications was similar in the older (28.1%) and younger (34.4%) groups (P = .10). One-, 3-, and 5-year disease-free survival rates were 57.6%, 32.9%, and 16.4%, respectively, in the younger group and 67.9%, 29.2%, and 19.5%, respectively, in the older group (P = .72). One-, 3-, and 5-year participant survival rates were 84.1%, 51.9%, and 33.3%, respectively, in the older group and 93.6%, 63%, and 28%, respectively, in the younger group (P = .50). CONCLUSIONS: Resection of colorectal liver metastases in older adults can be performed with low mortality and morbidity and offers a long-time survival advantage to many of these individuals. Based on the results of this case-control study, older adults should be considered for surgical treatment whenever possible.
Authors: Laurent Sulpice; Michel Rayar; Boris Campillo; Claire Pery; Antoine Guillaud; Bernard Meunier; Karim Boudjema Journal: World J Surg Date: 2014-04 Impact factor: 3.352
Authors: Neil H Bhayani; Omar Hyder; Wayne Frederick; Richard D Schulick; Christopher L Wolgang; Kenzo Hirose; Barish Edil; Joseph M Herman; Michael A Choti; Timothy M Pawlik Journal: Surgery Date: 2012-08 Impact factor: 3.982