Hepatic resection for malignancy in the elderly

• Published in: The American surgeon Vol. 61; no. 10; p. 889
• Main Authors: Cosenza, C A, Hoffman, A L, Podesta, L G, Sher, L, Lopez, R R, Lugo, D, Makowka, L
• Format: Journal Article
• Language: English
• Published: United States 01.10.1995
• Subjects: Age Factors; Aged; Comorbidity; Hepatectomy - mortality; Humans; Liver Neoplasms - epidemiology; Liver Neoplasms - surgery; Middle Aged; Postoperative Complications - epidemiology; Retrospective Studies; Survival Analysis
• ISSN: 0003-1348; 1555-9823

Although elderly patients are accounted for in all large series of major hepatic resections, the role of age as a determinant of outcome remains unclear. At Cedars-Sinai Medical Center, we review a series of 20 major hepatectomies for neoplasia performed in patients older than 66 years of age (4 of them > or = 80 years old) over a 5-year period. A retrospective comparison was conducted with a group of 22 hepatectomies for malignancy performed in 20 patients younger than 59 years of age during the same time period. The younger group had a significantly greater degree of liver resected (12 trisegmentectomies vs 3). Although one operative death (5% mortality) was observed in the elderly group, no statistically significant difference was noted, when compared to the younger group (Chi-square, P = 0.48). Likewise, no significant difference in the complication rate (20% vs 33%) was noticed (Chi-square, P = 0.8). Severe postoperative liver dysfunction was present in 2 cases (10%) in the elderly group and one (4%) in the younger group. These patients underwent a right trisegmentectomy (TS). Nine patients from each group were resected without red blood cell transfusion. We conclude that major hepatic resection in elderly patients without severe comorbid disease is a safe procedure that is not associated with an increased perioperative morbidity or mortality rate.