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Hepatectomy in Elderly Patients: Does Age Matter?

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Abstract

Background

With the increase in average life expectancy in recent decades, the proportion of elderly patients requiring liver surgery is rising. The aim of the meta-analysis reported here was to evaluate the safety and efficacy of hepatectomy in elderly patients.

Methods

An extensive electronic search was performed for relevant articles that compare the outcomes of hepatectomy in patients ≥70 years of age with those in younger patients prior to October 2012. Analysis of pooled data was performed with RevMan 5.0.

Results

Twenty-eight observational studies involving 15,480 patients were included in the analysis. Compared with the younger patients, elderly patients experienced more complications (31.8 vs 28.7 %; P = 0.002), mainly as a result of increased cardiac complications (7.5 vs 1.9 %; P < 0.001) and delirium (11.7 vs 4.5 %; P < 0.001). Postoperative major surgical complications (12.6 vs 11.3 %; P = 0.55) and mortality (3.6 vs 3.3 %; P = 0.68) were comparable between elderly and younger patients. For patients with malignancies, both the 5-year disease-free survival (26.5 vs 26.3 %; P = 0.60) and overall survival (39.5 vs 40.7 %; P = 0.29) did not differ significantly between the two groups.

Conclusions

Postoperative major surgical complications, mortality, and long-term results in elderly patients seem to be comparable with those in younger patients, suggesting that age alone should not be considered a contraindication for hepatectomy.

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Authors and Affiliations

  1. Department of Hepatobiliary & Pancreatovascular Surgery, Oncologic Center of Xiamen, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, Fujian, People’s Republic of China

    Yanming Zhou, Zuobing Zhang, Xiaobin Liu, Lupeng Wu & Bin Li

  2. Department IV of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, People’s Republic of China

    Xiaofeng Zhang

  3. Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, People’s Republic of China

    Yumin Li

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  1. Yanming Zhou
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  2. Xiaofeng Zhang
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  3. Zuobing Zhang
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  4. Xiaobin Liu
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  5. Lupeng Wu
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  6. Yumin Li
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  7. Bin Li
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Correspondence to Yanming Zhou.

Additional information

Yanming Zhou and Fengxiao Zhang contributed equally to this study.

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Zhou, Y., Zhang, X., Zhang, Z. et al. Hepatectomy in Elderly Patients: Does Age Matter?. World J Surg 37, 2899–2910 (2013). https://doi.org/10.1007/s00268-013-2184-5

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  • DOI: https://doi.org/10.1007/s00268-013-2184-5

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