Vito De Blasi1,2,3, Riccardo Memeo1,2,3, René Adam4, Diane Goéré5, Daniel Cherqui4, Jean Marc Regimbeau6, Michel Rivoire7, Laura Ornella Perotto1,2,3, Francis Navarro8, Antonio Sa Cunha4, Patrick Pessaux1,2,3. 1. Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, Strasbourg, France. 2. Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France. 3. General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg, France. 4. Department of Surgery, Hôpital Paul Brousse, Villejuif, France. 5. Department of Surgery, Institut Gustave Roussy, Villejuif, France. 6. Department of Surgery, Centre Hospitalier et Universitaire, Amiens, France. 7. Department of Surgery, Centre Léon Bérard, Lyon, France. 8. Department of Digestive Surgery, Université de Montpellier, Hôpital Saint-Eloi, Montpellier, France.
Abstract
BACKGROUND: The aim of this study was to evaluate the results of major hepatectomies for metastasis in elderly colorectal cancer patients, for whom limited data exist in the literature. METHODS: From January 2006 to January 2013, 3,034 patients underwent hepatectomy for colorectal liver metastasis in 32 French surgical centers. Repeat hepatectomies were excluded from the study. Based on a 1: 4 propensity score matching model, 42 patients aged ≥80 (OG) were matched with 168 patients <80 years (YG) in order to obtain 2 well-balanced and homogeneous groups with regards to therapy and prognostic factors. RESULTS: The unmatched cohort consisted of 744 patients (OG: n = 42; YG: n = 702). After PS matching, there was no difference in terms of general morbidity, rates of Dindo-Clavien score ≥III (OG: 16% vs. YG: 21%, p = 0.663), surgical morbidity (OG: 16% vs. YG: 21%, p = 0.663), reoperation (OG:10% vs. YG: 5%, p = 0.263), 90-day mortality (OG: 0% vs. YG:2%, p = 1), and total median hospital stay (OG: 12 vs. YG: 12, p = 0.972). Both groups experienced similar 3- and 5-year overall survival (82 and 82% OG vs.78 and 67% YG) and disease-free survival (40 and 35% OG vs. 45 and 35% YG at 3 and 5 years). CONCLUSIONS: No difference in perioperative and postoperative outcomes and disease-free and overall survival was found. Major hepatectomy in selected octogenarian patients is safe and feasible.
BACKGROUND: The aim of this study was to evaluate the results of major hepatectomies for metastasis in elderly colorectal cancerpatients, for whom limited data exist in the literature. METHODS: From January 2006 to January 2013, 3,034 patients underwent hepatectomy for colorectal liver metastasis in 32 French surgical centers. Repeat hepatectomies were excluded from the study. Based on a 1: 4 propensity score matching model, 42 patients aged ≥80 (OG) were matched with 168 patients <80 years (YG) in order to obtain 2 well-balanced and homogeneous groups with regards to therapy and prognostic factors. RESULTS: The unmatched cohort consisted of 744 patients (OG: n = 42; YG: n = 702). After PS matching, there was no difference in terms of general morbidity, rates of Dindo-Clavien score ≥III (OG: 16% vs. YG: 21%, p = 0.663), surgical morbidity (OG: 16% vs. YG: 21%, p = 0.663), reoperation (OG:10% vs. YG: 5%, p = 0.263), 90-day mortality (OG: 0% vs. YG:2%, p = 1), and total median hospital stay (OG: 12 vs. YG: 12, p = 0.972). Both groups experienced similar 3- and 5-year overall survival (82 and 82% OG vs.78 and 67% YG) and disease-free survival (40 and 35% OG vs. 45 and 35% YG at 3 and 5 years). CONCLUSIONS: No difference in perioperative and postoperative outcomes and disease-free and overall survival was found. Major hepatectomy in selected octogenarian patients is safe and feasible.