Operative morbidity and survival following hepatectomy for colorectal liver metastasis in octogenarians: A contemporary case matched series Journal Article


Authors: Leal, J. N.; Sadot, E.; Gonen, M.; Lichtman, S.; Kingham, T. P.; Allen, P. J.; DeMatteo, R. P.; Jarnagin, W. R.; D'Angelica, M. I.
Article Title: Operative morbidity and survival following hepatectomy for colorectal liver metastasis in octogenarians: A contemporary case matched series
Abstract: 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. © 2016 International Hepato-Pancreato-Biliary Association Inc.
Journal Title: HPB
Volume: 19
Issue: 2
ISSN: 1365-182X
Publisher: Elsevier Science, Inc.  
Date Published: 2017-02-01
Start Page: 162
End Page: 169
Language: English
DOI: 10.1016/j.hpb.2016.09.009
PROVIDER: scopus
PUBMED: 27914765
PMCID: PMC5608029
DOI/URL:
Notes: Article -- Export Date: 2 March 2017 -- Source: Scopus
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MSK Authors
  1. Ronald P DeMatteo
    597 DeMatteo
  2. Mithat Gonen
    701 Gonen
  3. Stuart Lichtman
    165 Lichtman
  4. Peter Allen
    436 Allen
  5. William R Jarnagin
    583 Jarnagin
  6. T Peter Kingham
    281 Kingham
  7. Julie Leal
    12 Leal
  8. Eran Sadot
    35 Sadot