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Age greater than 60 years in patients undergoing liver resection for colorectal liver metastases is an independent prognostic factor of an increased postoperative non-surgical complication rate and of overall survival

  • Retrospective Study
  • Published:
Hellenic Journal of Surgery

Abstract

Aim

To evaluate the effect of advanced age on peri-operative complications, recovery of liver function and overall survival in patients undergoing hepatectomy for colorectal liver metastases.

Methods

Consecutive patients with colorectal liver metastases, who underwent potentially curative hepatectomy in two institutions in the UK from 2005 to 2012, were enrolled in this retrospective study. For each patient the institutional electronic records were interrogated and data were collected.

Results

A total of 260 patients were enrolled, 150/260 (57.7%) of whom were older than 60 years of age. 113 complications were recorded occurring in 97/260 of patients (37.3%). Univariate analysis of factors influencing the peri-operative morbidity showed that there was a significant association with an age greater than 60 years. This association remained significant in multivariate analysis (HR 1.92; 95% CI, 1.10-3.36; P=0.02). The number of technical surgical complications was comparable between the young and older group of patients (p=0.449). However, complications, which were not surgical such as pulmonary and cardiovascular, were higher in the older age group (p=0.031). Indices of pre-operative liver function (bilirubin, albumin, ALT) were comparable between the two age groups (p>0.5) and there was no difference in functional recovery of the liver. Although age greater than 60 years was not associated with reduced DFS, it was associated with decreased OS both in univariate and multivariate analysis (HR 2.45; 95% CI, 1.41-4.25;P=0.001).

Conclusion

An age greater than 60 years is an independent prognostic factor of an increased postoperative nonsurgical complication rate and of decreased overall survival in patients undergoing partial hepatectomy for colorectal liver metastases. In this age group of patients significant post-operative complications relate not to the technical complexities or scale of procedure, but to the baseline physiological performance characteristics of the patient.

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Authors and Affiliations

  1. Department of Academic Surgery, The Royal Marsden NHS Trust, Fulham Road, London, UK

    Alexandros Giakoustidis, K. Neofytou, A. Z. Khan & S. Mudan

  2. Department of Surgery, The London Clinic, 116 Harley Street, W1G 7JL, London, UK

    Alexandros Giakoustidis, A. Koffas, R. Williams & S. Mudan

  3. Institute of Hepatology, Foundation for Liver Research, London, UK

    Alexandros Giakoustidis, A. Koffas & S. Mudan

  4. Division of Transplantation, Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece

    D. Giakoustidis

  5. 1st Department of Surgery, Democritus University of Thrace, Thrace, Greece

    E. Louri

  6. Department of Surgery and Cancer, Faculty of Medicine, Imperial, London, UK

    S. Mudan

Authors
  1. Alexandros Giakoustidis
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  2. K. Neofytou
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  3. A. Koffas
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  4. D. Giakoustidis
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  5. E. Louri
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  6. A. Z. Khan
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  7. R. Williams
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  8. S. Mudan
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Correspondence to Alexandros Giakoustidis.

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Giakoustidis, A., Neofytou, K., Koffas, A. et al. Age greater than 60 years in patients undergoing liver resection for colorectal liver metastases is an independent prognostic factor of an increased postoperative non-surgical complication rate and of overall survival. Hellenic J Surg 88, 336–346 (2016). https://doi.org/10.1007/s13126-016-0343-5

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  • DOI: https://doi.org/10.1007/s13126-016-0343-5

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