Richard Bell1, Sanjay Pandanaboyana2,3, Saira Nisar4, Vivek Upasani4, Giles Toogood4, J Peter Lodge4, K Raj Prasad4. 1. 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. 2. Department of Hepatobiliary Surgery, Auckland City Hospital, Auckland, New Zealand. 3. Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 4. Department of Hepatobiliary and Transplant Surgery, St James University Hospital, ICU Offices, Level 3 Bexley Wing, Leeds, LS9 7TF, UK.
Abstract
INTRODUCTION: 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. METHOD: 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. RESULTS: 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. CONCLUSION: Well-selected patients aged ≥75 should be considered for MH followed by adjuvant chemotherapy.
INTRODUCTION: 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. METHOD: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. RESULTS: 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. CONCLUSION: Well-selected patients aged ≥75 should be considered for MH followed by adjuvant chemotherapy.
Entities:
Keywords:
Age; Colorectal liver metastases; Elderly; Major hepatectomy
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