Hepatic resection for malignant liver tumours in the elderly

a systematic review and meta-analysis

Kevin Phan*, Vincent Vinh Gia An, Hakeem Ha, Steven Phan, Vincent Lam, Henry Pleass

*Corresponding author for this work

Research output: Contribution to journalReview article

20 Citations (Scopus)

Abstract

Background: The number of elderly patients undergoing hepatic resection for surgical treatment of benign and malignant cancers is increasing. However, there is limited clinical data on the complications and long-term survival rates associated with liver surgery in the elderly patients (≥70 years) versus younger patients for malignant liver conditions. Methods: Six electronic databases were searched for original published studies comparing elderly (≥70) versus younger (<70) cohorts for malignant liver tumours. Data were extracted and analysed according to predefined clinical endpoints. Results: Twenty-seven comparative studies were identified, including 4769 elderly patients versus 15855 younger patients (n = 20624). There was significantly higher 30-day mortality in the elderly colorectal liver metastasis group (P < 0.00002) and significant difference between elderly and young in terms of overall survival (hazard ration (HR), 1.10; P = 0.02). However, there was no difference in disease-free survival (HR, 1.05; P = 0.27). Post-operative pneumonia, renal failure and infection were more frequent in the elderly group. Conclusions: Liver resection for malignant hepatic tumours in the elderly is associated with a greater 30-day mortality and overall mortality when compared with younger cohorts, but similar disease-free survival. Length of stay and transfusions were not significantly different while pneumonia, renal failure and infections were more frequent in the elderly group.

Original languageEnglish
Pages (from-to)815-822
Number of pages8
JournalANZ Journal of Surgery
Volume85
Issue number11
DOIs
Publication statusPublished - 1 Nov 2015
Externally publishedYes

Keywords

  • Elderly
  • Hepatectomy
  • Liver resection
  • Malignant liver disease

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