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15.12.2020 | original article

Liver resections for colorectal liver metastases in elderly patients

Zeitschrift:
European Surgery
Autoren:
M.D., PhD. Prof. Vladislav Treska, M.D., PhD Assoc. Prof. Tomas Skalicky, MN.D., PhD Prof. Vaclav Liska, M.D. Jakub Fichtl, M.D. Jan Bruha
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Summary

Background

The aim of this study was to evaluate the short- and long-term results and risk factors of liver surgery in patients over the age of 70 following liver resection for colorectal liver metastases.

Methods

A total of 650 patients with an average age of 63.8 ± 9.3 years were evaluated. We compared groups of patients younger and older than 70 years of age. Time of hospitalisation, 30-day postoperative morbidity and mortality, overall and recurrence-free survival, the number and largest diameter of metastases, small and large liver resections, and the interval between primary colorectal and liver surgery were evaluated according to the results of liver resections.

Results

Length of hospitalisation, 30-day postoperative morbidity and mortality, and long-term results did not differ between groups of patients. Pulmonary embolism and confusion had a higher incidence in patients ≥70 years old (p < 0.02 and 0.05, respectively). Diameter of the largest metastasis ≥50 mm was a negative prognostic factor for long-term results in patients ≥70 years old (p < 0.04, HR 1.7, 95% CI 1.0–2.9 and p < 0.03, HR 1.5, 95% CI 1.0–2.3, respectively). Large liver resections had worse long-term results in patients ≥70 years old (p < 0.01, HR 2.1, 95% CI 1.2–3.8 and p < 0.05, HR 1.5, 95% CI 0.9–2.3, respectively).

Conclusion

Our results confirm the safety of liver resections for colorectal liver metastases in elderly patients. Parenchymal sparing surgery should be the method of choice. Very early and intensive postoperative mobilisation and respiratory and mental rehabilitation is essential.

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