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

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• 作者：Julie N. Leal¹ ; Eran Sadot¹ ; Mithat Gonen² ; Stuart Lichtman³ ; T. Peter Kingham¹ ; Peter J. Allen¹ ; Ronald P. DeMatteo¹ ; William R. Jarnagin¹ ; Michael I. D'Angelica¹ ; ^{dangelim@mskcc.org}
• 刊名：HPB
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：19
• 期：2
• 页码：162-169
• 全文大小：467 K
• 卷排序：19

文摘

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.MethodsPatients 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.ResultsFrom 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).ConclusionsHepatectomy 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.