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2006 Abstracts: The Impact of Age on Hepatic Resection for Colorectal Metastasis
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The Impact of Age on Hepatic Resection for Colorectal Metastasis
Chandrakanth Are, Mithat Gonen, Michael D'Angelica, Ronald P. DeMatteo, Yuman Fong, Leslie H. Blumgart, William R. Jarnagin; Department of Surgery, Memorial Sloan Kettering Cancer Centre, New York, NY

INTRODUCTION: Hepatic resection for colorectal metastasis (CRM) is increasingly performed in older patients. This study analyzes the impact of age on the results of hepatic resection for CRM in a large single centre series. MATERIALS AND METHODS: All patients undergoing hepatic resection for CRM from 1991 to 2003 were identified. Patients were divided into two age groups (Group I: ≤ 70 yrs and Group II:>70 yrs of age) and complications were graded from 0 (none) to 5 (death). Five year survival and morbidity were compared between both the groups. Morbidity was correlated to other potential predictors such as, transfusion, major hepatic resection (≥3 segments), body mass index (BMI) and pre operative co-morbidities. RESULTS: A total of 1119 patients underwent hepatic resection for CRM during this period. The majority of patients were ≤ 70 yrs (Group I=842 patients, 75%) compared to 277 patients who were > 70 yrs of age (Group II= 25%). There was no difference in overall morbidity (44 and 42%, p= 0.5) or major morbidity (55 and 57%, p= 0.7) between both the groups. The need for transfusion and the rate of major hepatic resection were similar in both groups (56 and 58 %, 50 and 48 % respectively) and did not affect the morbidity. In patients with BMI > 30, there was a statistically insignificant increase in complications in Group II when compared to Group I (65 % vs 50 %, p= 0.15). The presence of pre-op co-morbidity did not affect the outcome between the two groups. The five year survival for the two groups was 37.5 and 36.8 % (p =0.5) respectively. CONCLUSION: This study provides evidence that hepatic resection for colorectal metastasis is safe and effective in older patients. Age alone should therefore not factor into the decision regarding hepatic resection for colorectal metastasis
Table: 1

MORBIDITY

AGE 70 YRS (% )

AGE > 70 YRS (% )

p

Overall morbidity

44

42

0.5

Major morbidity

55

57

0.7

Without transfusion

36

29

0.17

With transfusion

56

58

0.68

Minor hepatic resection

35

32

0.54

Major hepatic resection

50

48

0.80

BMI 30

44

39

0.26

BMI > 30

50

65

0.15

Without pre op co morbidity

41

38

0.82

With pre op co morbidity

51

44

0.14

5 year survival

37.5 %

36.8%

0.5


Total number of patients= 1119.


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