Major liver resections in the elderly-is an aggressive approach justified?
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Major liver resections in the elderly-is an aggressive approach justified? / Bockhorn, Maximilian; Sotiropoulos, Georgios C; Sgourakis, George; Neuhaus, Jan P; Molmenti, Ernesto P; Lang, Hauke; Frilling, Andreja; Broelsch, Christoph E.
in: INT J COLORECTAL DIS, Jahrgang 24, Nr. 1, 1, 2009, S. 83-86.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Major liver resections in the elderly-is an aggressive approach justified?
AU - Bockhorn, Maximilian
AU - Sotiropoulos, Georgios C
AU - Sgourakis, George
AU - Neuhaus, Jan P
AU - Molmenti, Ernesto P
AU - Lang, Hauke
AU - Frilling, Andreja
AU - Broelsch, Christoph E
PY - 2009
Y1 - 2009
N2 - BACKGROUND AND AIMS: As the mean life expectancy rises, the incidence of patients 75 years of age and older who present with colorectal liver metastases continues to increase. The purpose of our study was to evaluate the outcome of major hepatic resections in the elderly population. PATIENT AND METHODS: From April 1998 to December 2006, 572 consecutive patients with colorectal liver metastases were treated at our Institution. Of these, 59 were 75 years or older. There was an intent to proceed with major liver resections in all cases. Data were analyzed according to diagnosis, comorbidities, extent of liver resection, postoperative complications, overall survival, and disease-free survival. RESULTS: Surgical treatment included right hepatectomies (n = 8), left hepatectomies (n = 4), and sectionectomies (more than three segments; n = 33). Fourteen (n = 14) patients received an explorative laparotomy alone. Morbidity and hospital mortality were 10% and 3%, respectively. Overall survival of 1, 3, and 5 years was 90%, 64%, and 33%, respectively. The corresponding disease-free survival was 74%, 42%, and 32%. Resection margin (R class) was the only predictor of survival by both uni- and multivariate analyses. CONCLUSION: Hepatic resections can be performed safely in selected patients 75 years of age or older.
AB - BACKGROUND AND AIMS: As the mean life expectancy rises, the incidence of patients 75 years of age and older who present with colorectal liver metastases continues to increase. The purpose of our study was to evaluate the outcome of major hepatic resections in the elderly population. PATIENT AND METHODS: From April 1998 to December 2006, 572 consecutive patients with colorectal liver metastases were treated at our Institution. Of these, 59 were 75 years or older. There was an intent to proceed with major liver resections in all cases. Data were analyzed according to diagnosis, comorbidities, extent of liver resection, postoperative complications, overall survival, and disease-free survival. RESULTS: Surgical treatment included right hepatectomies (n = 8), left hepatectomies (n = 4), and sectionectomies (more than three segments; n = 33). Fourteen (n = 14) patients received an explorative laparotomy alone. Morbidity and hospital mortality were 10% and 3%, respectively. Overall survival of 1, 3, and 5 years was 90%, 64%, and 33%, respectively. The corresponding disease-free survival was 74%, 42%, and 32%. Resection margin (R class) was the only predictor of survival by both uni- and multivariate analyses. CONCLUSION: Hepatic resections can be performed safely in selected patients 75 years of age or older.
KW - Comorbidity
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Aged, 80 and over
KW - Disease-Free Survival
KW - Proportional Hazards Models
KW - Hepatectomy methods
KW - Liver Neoplasms mortality
KW - Colorectal Neoplasms pathology
KW - Hospital Mortality
KW - Postoperative Complications
KW - Comorbidity
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Aged, 80 and over
KW - Disease-Free Survival
KW - Proportional Hazards Models
KW - Hepatectomy methods
KW - Liver Neoplasms mortality
KW - Colorectal Neoplasms pathology
KW - Hospital Mortality
KW - Postoperative Complications
M3 - SCORING: Zeitschriftenaufsatz
VL - 24
SP - 83
EP - 86
JO - INT J COLORECTAL DIS
JF - INT J COLORECTAL DIS
SN - 0179-1958
IS - 1
M1 - 1
ER -