Short-and long-term outcomes of laparoscopic hepatectomy for elderly patients with colorectal liver metastases
Chai Lixin1, Pan Zhijian1, Wu Wei1, Bai Guang2
1 Department of Gastrointestinal and Hepatobiliary Surgery, Affiliated Hospital of Hangzhou Normal University, Hangzhou 310000, China; 2 Department of General Surgery, Affiliated Hospital of Jinzhou Medical University
Abstract：Objective To evaluate the short-and long-term outcomes of laparoscopic hepatectomy (LH) for colorectal liver metastases (CRLM) in elderly patients. Methods From January 2010 to January 2017, LH was performed for consecutive 207 patients who were 60 years old and above and had CRLM. Based on their age at the LH, the patients were divided into the elderly group (70 years old and above, 68 patients) and the middle-aged group (from 60 to 69 years old, 139 patients). The short-term and long-term outcomes were compared between the two groups. Results Compared to the middle-aged group, the elderly group had higher values for age, Charlson comorbidity index, proportion of preoperative chemotherapy, and American Society of Anesthesiologists score. No other significant differences were observed in the preoperative data. The elderly group had a higher conversion rate, compared to the middle-aged group, although no significant differences were observed in the surgical procedures, surgical time, intraoperative blood losses, numbers and severities of postoperative 90-day complications, postoperative 90-day mortality rates, pathology results, and other short-term outcomes. Long-term follow-up revealed similar rates of recurrence, disease-free survival, and overall survival in the two groups. Multivariate analysis revealed that age did not independently predict overall survival or disease-free survival. Conclusion Similar short-and long-term outcomes were observed after LH for CRLM in elderly and middle-aged patients. Thus, advanced age is not a contraindication for LH treatment in this setting.
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