The Impact of Advancing Age on Recurrence and Survival Following Major Hepatectomy for Colorectal Liver Metastases. J Gastrointest Surg 2017 Feb;21(2):266-274
Date
10/23/2016Pubmed ID
27770289DOI
10.1007/s11605-016-3296-7Scopus ID
2-s2.0-84992096781 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
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.
Author List
Bell R, Pandanaboyana S, Nisar S, Upasani V, Toogood G, Lodge JP, Prasad KRAuthor
Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAge Factors
Aged
Aged, 80 and over
Antineoplastic Agents
Chemotherapy, Adjuvant
Colorectal Neoplasms
Female
Hepatectomy
Humans
Liver Neoplasms
Male
Middle Aged
Neoplasm Recurrence, Local
Survival Analysis
