Impact of Advanced Age on the Outcome of Liver Resection

Abstract

The aim of this retrospective study was to evaluate the influence of age on the outcome of liver resection. A total of 129 consecutive liver resections were divided into two groups: > or = 70 years old [old group (O-group)] and < 70 years old [young group (Y-group)]. The two groups were first compared for the variables potentially affecting the postoperative course, including diagnosis, concomitant diseases, previous abdominal surgery, type of operation (major or minor resection), associated procedures, presence and length of portal clamping, intraoperative blood losses and transfusions, and length of operation. The outcome of liver resections was evaluated in terms of postoperative mortality, morbidity, transfusions, and length of hospitalization. The Y-group included 97 resections in 95 patients, aged 55.9 +/- 10.5 years (mean +/- SD; range: 23-69 years), and the O-group included 32 resections in 32 patients, aged 73.7 +/- 3.2 years (mean +/- SD; range: 70-82 years. The O-group included more hepatocellular carcinomas (46.9% versus 20.6%, p = 0.002) and cardiovascular diseases (15.2% versus 1.0%, p = 0.004). The two groups were comparable (p > 0.05) when evaluated for all other listed variables. As regards the postoperative outcome, the length of hospitalization was similar (median, range: 9.5 days, 5-60 days in the Y-group and 9 days, 5-48 days in the O-group) and the need for postoperative transfusions were not statistically different. Mortality included one case among young patients, while no deaths were recorded among elderly patients. Postoperative morbidity was higher in Y-group than in O-group (21.6% versus 9.4%, p = 0.2). In conclusion, the age factor does not negatively affect the outcome of liver resections.

Systematic Review and Meta-Analysis of Liver Resection for Colorectal Metastases in Elderly Patients

“…Most studies evaluating the outcome after hepatectomy in elderly patients have included non-colorectal malignancies, mostly HCC [40-44]. Due to the different pathophysiology of the tumour and the potential differences between patients, these studies were not included in this systematic review.…”

p66Shc has a pivotal function in impaired liver regeneration in aged mice by a redox-dependent mechanism

“…7,8 Aging is an issue of growing concern in modern surgery and one which must be resolved in the near future. The influence of aging on the outcome of surgery has already been extensively analyzed and reported in some fields such as liver surgery.…”

“…Hepatic resection is a common surgical treatment for a wide range of liver diseases. 7,9,10 Recently, more hepatic resections have been performed in patients over the age of 60 years, with encouraging results. 7,11 The aged population, however, is predisposed to a variety of diseases and pathological conditions, which may contribute to a marked increase in morbidity in this subpopulation.…”

“…7,9,10 Recently, more hepatic resections have been performed in patients over the age of 60 years, with encouraging results. 7,11 The aged population, however, is predisposed to a variety of diseases and pathological conditions, which may contribute to a marked increase in morbidity in this subpopulation. 12 The incidence of liver disease increases with age, but the cellular and subcellular mechanisms that underlie this suspected predisposition to pathology remain unresolved.…”

Influence of Preoperative Chemotherapy on the Risk of Major Hepatectomy for Colorectal Liver Metastases

“…8 • Use the standard errors to exclude outlier patients whose data would otherwise cause spurious management decisions. 9 • Combine the financial information with assessments of competition 10 and its impact on market share, 11 as well as shorter-term operational decisions, to form a rational tactical decision-making policy. 12 • Combine 6 results with assessments 13,14 of what differentiates one hospital from another for strategic decision making.…”