Surgical treatment of liver metastases from colorectal carcinoma in elderly patients. When is it worthwhile?
Clin Transl Oncol
; 9(6): 392-400, 2007 Jun.
Article
en En
| MEDLINE
| ID: mdl-17594954
BACKGROUND: The elderly are under-represented in series of patients operated on for colorectal liver metastases (LM). OBJECTIVE: To analyse the influence of age on surgery of colorectal LM, and the identification of factors that could be used as exclusion criteria. PATIENTS AND METHODS: Six hundred and forty-eight patients underwent liver resection between 1990 and 2006. Demographic data, primary tumour related variables, stage of the disease, morbidity, mortality, survival and recurrence were prospectively recorded. RESULTS: One hundred and sixty of 648 patients (25%) were 70 years old or older. Postoperative mortality was significantly higher in elderly patients (8% vs. 3%, p=0.008). Morbidity was also higher (41% vs. 34%, p=0.008). Survival rate at 1, 3 and 5 years was 88%, 62% and 45% respectively in patients younger than 70 years, and 82%, 48% and 36% in the elderly (p=0.007). Excluding the postoperative mortality, the figures were 90%, 64% and 46%. 90%, 53% and 38% (p=0.061). Disease-free survival rates at 1, 3 and 5 years excluding postoperative mortality were 68%, 32% and 25% in younger patients, compared to 68%, 34% and 30% (p=0.71) in the elderly. Major liver resections increased mortality in the elderly. In the multivariate analyses only a tumour size equal to or more than 10 cm significantly increased the postoperative mortality risk in elderly patients. CONCLUSIONS: The elderly have a higher mortality. In recent years that difference has been markedly reduced. Excluding the postoperative mortality, the overall survival and disease-free survival are similar between both groups. The criteria to indicate surgery must be the same in both groups.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Colorrectales
/
Neoplasias Hepáticas
Tipo de estudio:
Prognostic_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Transl Oncol
Año:
2007
Tipo del documento:
Article
País de afiliación:
España
Pais de publicación:
Italia