Liver and Multivisceral Transplant Center, Hepatopancreatic and Biliary Surgery, University of Modena and Reggio Emilia, Modena, Italy.
J Am Geriatr Soc. 2011 Dec;59(12):2282-90. doi: 10.1111/j.1532-5415.2011.03734.x.
To assess the safety and long-term results of hepatic resection of colorectal liver metastases (CLM) in older adults.
Case-control.
Single liver and multivisceral transplant center.
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.
Postoperative complications and survival rates.
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).
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.
评估老年患者结直肠肝转移（CLM）行肝切除术的安全性和长期疗效。
病例对照研究。
单肝和多器官移植中心。
CLM 患者：32 名年龄≥70 岁（老年组）和 32 名年龄<70 岁（年轻组），按性别、原发肿瘤部位、诊断时肝转移、转移数量、最大肿瘤直径、切缘浸润、肝切除术类型和肝切除术时机进行 1:1 匹配。
术后并发症和生存率。
两组患者术前临床特征无显著差异。老年组（28.1%）和年轻组（34.4%）的累积术后并发症发生率相似（P=0.10）。年轻组的 1 年、3 年和 5 年无疾病生存率分别为 57.6%、32.9%和 16.4%，老年组分别为 67.9%、29.2%和 19.5%（P=0.72）。老年组的 1 年、3 年和 5 年患者生存率分别为 84.1%、51.9%和 33.3%，年轻组分别为 93.6%、63%和 28%（P=0.50）。
老年患者结直肠肝转移切除术的死亡率和发病率较低，能为许多患者带来长期生存优势。基于本病例对照研究结果，只要有可能，老年患者应考虑进行手术治疗。
