Resumen de Liver Resection for Colorectal Metastases in Older Adults:: A Paired Matched Analysis
Fabrizio di Benedetto, Massimiliano Berretta, Giuseppe d'Amico, Roberto Montalti, Nicola de Ruvo, Nicola Cautero, Gian Piero Guerrini, Roberto Ballarin, Mario Spaggiari, Giuseppe Tarantino, Stefano di Sandro, Anna Pecchi, Gabriele Luppi, Giorgio Enrico Gerunda
Objectives: To assess the safety and long-term results of hepatic resection of colorectal liver metastases (CLM) in older adults.
Design: Case�control.
Setting: Single liver and multivisceral transplant center.
Participants: Individuals with CLM: 32 aged 70 and older (older group) and 32 younger than 70 (younger group) matched in a 1:1 ratio according to sex, primary tumor site, liver metastases at diagnosis, number of metastases, maximum tumor size, infiltration of cut margin, type of hepatic resection, and hepatic resection timing.
Measurements: Postoperative complications and survival rates.
Results: There was no significant difference in preoperative clinical findings between the two study groups. The incidence of cumulative postoperative complications was similar in the older (28.1%) and younger (34.4%) groups (P = .10). One-, 3-, and 5-year disease-free survival rates were 57.6%, 32.9%, and 16.4%, respectively, in the younger group and 67.9%, 29.2%, and 19.5%, respectively, in the older group (P = .72). One-, 3-, and 5-year participant survival rates were 84.1%, 51.9%, and 33.3%, respectively, in the older group and 93.6%, 63%, and 28%, respectively, in the younger group (P = .50).
Conclusions: Resection of colorectal liver metastases in older adults can be performed with low mortality and morbidity and offers a long-time survival advantage to many of these individuals. Based on the results of this case�control study, older adults should be considered for surgical treatment whenever possible.
