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Laparoscopic major hepatectomy for colorectal liver metastases in elderly patients: a single-center, case-matched study

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Abstract

Background

The incidence of colorectal cancer liver metastases (CRLM) among elderly patients has increased; therefore, older patients are increasingly being considered for hepatic resection. However, data regarding the outcome of laparoscopic major hepatectomy (LMH) in elderly patients are limited. The aim of this study was to evaluate the safety and feasibility of LMH in elderly patients with CRLM.

Methods

From January 1998 to September 2013, a total of 31 patients aged ≥70 years (elderly group) were matched with 62 patients <70 years (young group) by demographics, tumor characteristics, and details of surgical procedures.

Results

The elderly group was characterized by a higher incidence of hypertension (41.9 vs. 17.7 %, P = 0.022), ≥2 comorbidities (32.3 vs. 11.3 %, P = 0.021), and lower prevalence of metastatic rectal cancer (12.9 vs. 38.7 %, P = 0.015). Intraoperative variables, such as surgical duration (300 vs. 240 min, P = 0.920), blood loss (400 vs. 300 mL, P = 0.361), and transfusion rate (9.7 vs. 12.9 %, P = 0.726), were not notably different between the groups. Postoperative mortality (0 vs. 0 %), complications (54.8 vs. 41.9 %, P = 0.276), and major complications (27.4 vs. 16.1 %, P = 0.303, respectively) were comparable between the groups. The 3-year overall survival rates were 61.7 % in the young group (median 40 months) and 57.9 % in the elderly group (median 39 months), respectively (P = 0.842).

Conclusions

Our results clearly demonstrated that LMH for CRLM could be safely performed in elderly patients; thus, advanced age itself should not be regarded as a contraindication for LMH.

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Acknowledgments

The authors thank Mahendran Govindasamy, Kenichiro Araki, and Satoshi Ogiso for coordinating patient follow-up and maintaining the prospective database that formed the basis of this study.

Disclosures

Takeo Nomi, David Fuks, Yoshikuni Kawaguchi, Frederic Mal, Yoshiyuki Nakajima, and Brice Gayet have no conflict of interest and financial ties to disclose.

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Authors and Affiliations

  1. Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris-Descartes, 42 Boulevard Jourdan, 75014, Paris, France

    Takeo Nomi, David Fuks, Yoshikuni Kawaguchi, Frederic Mal & Brice Gayet

  2. Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan

    Takeo Nomi & Yoshiyuki Nakajima

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  1. Takeo Nomi
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  2. David Fuks
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Correspondence to Takeo Nomi.

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Nomi, T., Fuks, D., Kawaguchi, Y. et al. Laparoscopic major hepatectomy for colorectal liver metastases in elderly patients: a single-center, case-matched study. Surg Endosc 29, 1368–1375 (2015). https://doi.org/10.1007/s00464-014-3806-1

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  • DOI: https://doi.org/10.1007/s00464-014-3806-1

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