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The impact of aging on morbidity and mortality after liver resection: a systematic review and meta-analysis

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Abstract

Surgery involving elderly patients is becoming increasingly common due to the rapid aging of societies all over the world. The objective of this study was to elucidate the prognostic differences between elderly and young patients who undergo liver resection. A systematic review based on the PRISMA flow diagram was conducted. Ovid Medline and PubMed were used to search for relevant literature published between January 2000 and March 2013, and the modified MINORS score was used to assess the methodological quality. In cases of hepatocellular carcinoma and miscellaneous liver tumors, the morbidity and mortality rate did not differ significantly between the elderly and young patients. For patients with colorectal metastatic liver cancer, the mortality of the young patients was 2.7 times lower than that of elderly patients. Our review of high-quality retrospective studies was able to elucidate the clinical risks of age on the outcomes after liver surgery in specific patient populations.

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References

  1. Centers for Disease Control and Prevention (CDC). Trends in aging––US and worldwide. MMWR Morb Mortal Wkly Rep. 2003;52:101–4.

    Google Scholar 

  2. From the Centers for Disease Control and Prevention. Public health and aging: trends in aging––US and worldwide. JAMA. 2003;289:1371–3.

    Article  Google Scholar 

  3. Straub RH, Cutolo M, Zietz B, Scholmerich J. The process of aging changes the interplay of the immune, endocrine and nervous systems. Mech Age Dev. 2001;122:1591–611.

    Article  CAS  Google Scholar 

  4. Nguyen KT, Marsh JW, Tsung A, Steel JJ, Gamblin TC, Geller DA. Comparative benefits of laparoscopic vs open hepatic resection: a critical appraisal. Arch Surg. 2011;146:348–56.

    Article  PubMed  Google Scholar 

  5. Mizuguchi T, Kawamoto M, Meguro M, Nakamura Y, Ota S, Hui TT, et al. Prognosis and predictors of surgical complications in hepatocellular carcinoma patients with or without cirrhosis after hepatectomy. World J Surg. 2013;37:1379–87.

    Article  PubMed  Google Scholar 

  6. Nanashima A, Abo T, Hamasaki K, Wakata K, Kunizaki M, Tou K, et al. Predictors of intraoperative blood loss in patients undergoing hepatectomy. Surg Today. 2013;43:485–93.

    Article  PubMed  Google Scholar 

  7. Shimada H, Tanaka K, Endou I, Ichikawa Y. Treatment for colorectal liver metastases: a review. Langenbecks Arch Surg. 2009;394:973–83.

    Article  PubMed  Google Scholar 

  8. Cauchy F, Fuks D, Belghiti J. HCC: current surgical treatment concepts. Langenbecks Arch Surg. 2012;397:681–95.

    Article  CAS  PubMed  Google Scholar 

  9. Hanazaki K, Kajikawa S, Shimozawa N, Mihara M, Shimada K, Hiraguri M, et al. Survival and recurrence after hepatic resection of 386 consecutive patients with hepatocellular carcinoma. J Am Coll Surg. 2000;191:381–8.

    Article  CAS  PubMed  Google Scholar 

  10. Ferrero A, Vigano L, Polastri R, Ribero D, Lo Tesoriere R, Muratore A, et al. Hepatectomy as treatment of choice for hepatocellular carcinoma in elderly cirrhotic patients. World J Surg. 2005;29:1101–5.

    Article  PubMed  Google Scholar 

  11. Huang J, Li BK, Chen GH, Li JQ, Zhang YQ, Li GH, et al. Long-term outcomes and prognostic factors of elderly patients with hepatocellular carcinoma undergoing hepatectomy. J Gastroint Surg. 2009;13:1627–35.

    Article  Google Scholar 

  12. Portolani N, Baiocchi GL, Coniglio A, Tiberio GA, Prestini K, Gheza F, et al. Limited liver resection: a good indication for the treatment of hepatocellular carcinoma in elderly patients. Jpn J Clin Oncol. 2011;41:1358–65.

    Article  PubMed  Google Scholar 

  13. Nagano Y, Nojiri K, Matsuo K, Tanaka K, Togo S, Ike H, et al. The impact of advanced age on hepatic resection of colorectal liver metastases. J Am Coll Surg. 2005;201:511–6.

    Article  PubMed  Google Scholar 

  14. Mazzoni G, Tocchi A, Miccini M, Bettelli E, Cassini D, De Santis M, et al. Surgical treatment of liver metastases from colorectal cancer in elderly patients. Int J Colorect Dis. 2007;22:77–83.

    Article  Google Scholar 

  15. Di Benedetto F, Berretta M, D’Amico G, et al. Liver resection for colorectal metastases in older adults: a paired matched analysis. J Am Geriatr Soc. 2011;59:2282–90.

    Article  PubMed  Google Scholar 

  16. Cook EJ, Welsh FK, Chandrakumaran K, Montalti R, De Ruvo N, Cautero N, et al. Resection of colorectal liver metastases in the elderly: does age matter? Colorect Dis. 2012;14:1210–6.

    Article  CAS  Google Scholar 

  17. Mizuguchi T, Kawamoto M, Meguro M, Hui TT, Hirata K. Preoperative liver function assessments to estimate the prognosis and safety of liver resections. Surg Today. 2014;44:1–10.

    Article  PubMed  Google Scholar 

  18. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.

    Article  PubMed  Google Scholar 

  19. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Lee CR, Lim JH, Kim SH, Ahn SH, Park YN, Choi GH, et al. A comparative analysis of hepatocellular carcinoma after hepatic resection in young versus elderly patients. J Gastroint Surg. 2012;16:1736–43.

    Article  Google Scholar 

  22. Adam R, Frilling A, Elias D, Laurent C, Ramos E, Capussotti L, et al. Liver resection of colorectal metastases in elderly patients. Br J Surg. 2010;97:366–76.

    Article  CAS  PubMed  Google Scholar 

  23. Kulik U, Framke T, Grosshennig A, Ceylan A, Bektas H, Klempnauer J, et al. Liver resection of colorectal liver metastases in elderly patients. World J Surg. 2011;35:2063–72.

    Article  CAS  PubMed  Google Scholar 

  24. Cescon M, Grazi GL, Del Gaudio M, Ercolani G, Ravaioli M, Nardo B, et al. Outcome of right hepatectomies in patients older than 70 years. Arch Surg. 2003;138:547–52.

    Article  PubMed  Google Scholar 

  25. Menon KV, Al-Mukhtar A, Aldouri A, Prasad RK, Lodge PA, Toogood GJ. Outcomes after major hepatectomy in elderly patients. J Am Coll Surg. 2006;203:677–83.

    Article  PubMed  Google Scholar 

  26. Shirabe K, Kajiyama K, Harimoto N, Gion T, Tsujita E, Abe T, et al. Early outcome following hepatic resection in patients older than 80 years of age. World J Surg. 2009;33:1927–32.

    Article  PubMed  Google Scholar 

  27. Reddy SK, Barbas AS, Turley RS, Gamblin TC, Geller DA, Marsh JW, et al. Major liver resection in elderly patients: a multi-institutional analysis. J Am Coll Surg. 2011;212:787–95.

    Article  PubMed  Google Scholar 

  28. Melloul E, Halkic N, Raptis DA, Tempia A, Demartines N. Right hepatectomy in patients over 70 years of age: an analysis of liver function and outcome. World J Surg. 2012;36:2161–70.

    Article  PubMed  Google Scholar 

  29. Yeh CN, Lee WC, Jeng LB, Chen MF. Hepatic resection for hepatocellular carcinoma in elderly patients. Hepatogastroenterology. 2004;51:219–23.

    PubMed  Google Scholar 

  30. Su CW, Lei HJ, Chau GY, Hung HH, Wu JC, Hsia CY, et al. The effect of age on the long-term prognosis of patients with hepatocellular carcinoma after resection surgery: a propensity score matching analysis. Arch Surg. 2012;147:137–44.

    Article  PubMed  Google Scholar 

  31. Ettorre GM, Sommacale D, Farges O, Sauvanet A, Guevara O, Belghiti J. Postoperative liver function after elective right hepatectomy in elderly patients. Br J Surg. 2001;88:73–6.

    Article  CAS  PubMed  Google Scholar 

  32. Gruttadauria S, Doria C, Vitale CH, Cintorino D, Foglieni CS, Fung JJ, et al. Preliminary report on surgical technique in hepatic parenchymal transection for liver tumors in the elderly: a lesson learned from living-related liver transplantation. J Surg Oncol. 2004;88:229–33.

    Article  PubMed  Google Scholar 

  33. Yeh CN, Jan YY, Chen MF. Influence of age on surgical treatment of peripheral cholangiocarcinoma. Am J Surg. 2004;187:559–63.

    Article  PubMed  Google Scholar 

  34. Aldrighetti L, Arru M, Calori G, Caterini R, Comotti L, Torri G, et al. Impact of age on the outcome of liver resections. Am Surg. 2004;70:453–60.

    PubMed  Google Scholar 

  35. Yeh CN, Jan YY, Chen MF. Hepatectomy for peripheral cholangiocarcinoma in elderly patients. Ann Surg Oncol. 2006;13:1553–9.

    Article  PubMed  Google Scholar 

  36. Caratozzolo E, Massani M, Recordare A, Bonariol L, Baldessin M, Bassi N. Liver resection in elderly: comparative study between younger and older than 70 years patients. Outcomes and implications for therapy. G Chir. 2007;28:419–24.

    CAS  PubMed  Google Scholar 

  37. Wynne HA, Cope LH, Mutch E, Rawlins MD, Woodhouse KW, James OF. The effect of age upon liver volume and apparent liver blood flow in healthy man. Hepatology. 1989;9:297–301.

    Article  CAS  PubMed  Google Scholar 

  38. Frith J, Jones D, Newton JL. Chronic liver disease in an ageing population. Age Ageing. 2009;38:11–8.

    Article  PubMed  Google Scholar 

  39. Yoshimura Y, Kubo S, Shirata K, Hirohashi K, Tanaka H, Shuto T, et al. Risk factors for postoperative delirium after liver resection for hepatocellular carcinoma. World J Surg. 2004;28:982–6.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan, No. 23591993 to T. Mizuguchi.

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Authors and Affiliations

  1. Department of Surgery I, Sapporo Medical University School of Medicine, Sapporo Medical University Hospital, Sapporo Medical University, S-1, W-16, Chuo-Ku, Sapporo, Hokkaido, 060-8543, Japan

    Toru Mizuguchi, Masaki Kawamoto, Makoto Meguro, Kenji Okita, Shigenori Ota, Masayuki Ishii, Tomomi Ueki, Toshihiko Nishidate, Yasutoshi Kimura, Tomohisa Furuhata & Koichi Hirata

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  1. Toru Mizuguchi
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  2. Masaki Kawamoto
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Correspondence to Toru Mizuguchi.

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Mizuguchi, T., Kawamoto, M., Meguro, M. et al. The impact of aging on morbidity and mortality after liver resection: a systematic review and meta-analysis. Surg Today 45, 259–270 (2015). https://doi.org/10.1007/s00595-014-0863-y

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  • DOI: https://doi.org/10.1007/s00595-014-0863-y

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