Ann Hepatobiliary Pancreat Surg.  2021 Feb;25(1):18-24. 10.14701/ahbps.2021.25.1.18.

How successful is liver resection for colorectal cancer liver metastases in patients over 75 years old?

• Mowbray NG
• Chin C
• Duncan P
• O’Reilly D
• Kaposztas Z
• Junnarkar S
• Kumar N

• KMID: 2513171
• DOI: http://doi.org/10.14701/ahbps.2021.25.1.18

Abstract

Backgrounds/Aims
As populations age, an increased incidence of colorectal cancer will generate an increase in colorectal cancer liver metastases (CRLM). In order to guide treatment decisions, this study aimed to identify the contemporary complication rates of elderly patients undergoing liver resection for CRLM in a, centralised, UK centre.
Methods
All patients undergoing operative procedures for CRLM between January 2013 and January 2019 were included. Patient, tumour and operative data were analysed, including the prognostic marker; tumour burden score.
Results
339 operations were performed on 289 consecutive patients with CRLM (272 patients ＜75 years old, 67 patients ≥75 years old). Median age was 66 years (range 20-93). There was no difference in major complication rates between the two age cohorts (6.65 vs. 6.0%, p=0.847) or operative mortality (1.1% vs. 1.4%, p=0.794). Younger patients had higher R1 resection rates (20.4% vs. 4.5%,p=0.002) and post-operative chemotherapy rates (60.3% vs. 35.8%,p＜ 0.001). The 1, 3 and 5-year OS was 90.2%, 70.5% and 52.3% respectively, median 70 months, with no difference between age cohorts (p=0.772). Tumour Burden score and operation type were independent predictors of overall survival.
Conclusions
Liver resection for CRLM in patients 75 years and older is feasible, safe and confers a similar 5-year survival rate to younger patients. The current outcomes from surgery are better than historical datasets.

Keyword

Liver; Colonic neoplasms; Neoplasm metastasis

Figure

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  Fig. 1 Flowchart illustrating patient inclusion in the study.

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  Fig. 2 Kaplan-Meier estimates of overall survival stratified by; (A) age category, p=0.772, and (B) tumour burden score, p=0.010.

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