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The Impact of Advancing Age on Recurrence and Survival Following Major Hepatectomy for Colorectal Liver Metastases

Lookup NU author(s): Sanjay PandanaboyanaORCiD


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© 2016, The Society for Surgery of the Alimentary Tract.Introduction: This study analysed the effect of age on survival in patients undergoing major hepatectomy (MH) for colorectal liver metastases (CRLM). The effect of adjuvant chemotherapy (AC) with age was also assessed. Method: Patients undergoing MH for CRLM between 1996 and 2011 were reviewed. Patients aged <75 or ≥75 were compared for disease-free (DFS) and overall survival (OS) as well as impact of AC on survival. Results: Seven hundred twenty-seven patients underwent MH of which 105 (14 %) were aged ≥75. Morbidity was greater in the ≥75 group (25 versus 34 %, p = 0.048). No difference was noted in mortality. There was no difference in DFS between the two groups at 5 years (16.8 vs 18.9 months (p = 0.570). OS was longer in the <75 group (38.6 vs 32.0 months (p = 0.001). DFS was better in groups receiving AC than those not (<75 24.2 vs 12.2 months (p = <0.001) and ≥75 24 vs 12.1 months (p = 0.007)). OS in the ≥75 group was improved in the group receiving AC compared to the ≥75 group not (41.1 vs 16.6 months, p = 0.005). Age ≥75 was not an independent risk factor for reduced DFS on multivariate analysis. Conclusion: Well-selected patients aged ≥75 should be considered for MH followed by adjuvant chemotherapy.

Publication metadata

Author(s): Bell R, Pandanaboyana S, Nisar S, Upasani V, Toogood G, Lodge JP, Prasad KR

Publication type: Article

Publication status: Published

Journal: Journal of Gastrointestinal Surgery

Year: 2017

Volume: 21

Issue: 2

Pages: 266-274

Print publication date: 01/02/2017

Online publication date: 21/10/2016

Acceptance date: 03/10/2016

ISSN (print): 1091-255X

ISSN (electronic): 1873-4626

Publisher: Springer New York LLC


DOI: 10.1007/s11605-016-3296-7

PubMed id: 27770289


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