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

Annals of Hepato-Biliary-Pancreatic Surgery 2021년 25권 1호 p.18 ~ 24
Mowbray Nicholas George, Chin Carven, Duncan Patricia, O’Reilly David, Kaposztas Zsolt, Junnarkar Sameer, Kumar Nagappan,
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 ( Mowbray Nicholas George ) - University Hospital of Wales Cardiff Liver Unit
 ( Chin Carven ) - Cardiff University School of Medicine
 ( Duncan Patricia ) - University Hospital of Wales Cardiff Liver Unit
 ( O’Reilly David ) - University Hospital of Wales Cardiff Liver Unit
 ( Kaposztas Zsolt ) - Moritz Kaposi Teaching General Hospital Department of Surgery
 ( Junnarkar Sameer ) - Tan Tock Seng Hospital Department of Surgery
 ( Kumar Nagappan ) - University Hospital of Wales Cardiff Liver Unit

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.

키워드

Liver; Colonic neoplasms; Neoplasm metastasis

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