Long-term outcome after liver surgery for colorectal metastases in elderly patients: a nationwide population-based study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Age alone is no longer a contraindication for resection of colorectal liver metastases (CRLM). The aim of this study was to compare survival after resection of CRLM across different age groups. METHODS: A population-based study of patients who underwent resection of CRLM in the Netherlands between 2014 and 2022 was performed. For survival analyses, data from 2014 to 2018 were used. Patients were divided into three groups: <70, 70-80, and ≥80 years. Main outcomes were overall survival (OS) and relative survival (RS), defined as survival relative to age-matched survival in the general population. Secondary outcomes included short-term postoperative outcome and risk factors influencing survival. RESULTS: Among 6415 patients, 3874 (60.3 %) were <70 years, 2042 (31.8 %) were 70-80, and 499 (7.7 %) were ≥80 years. Median OS was 54.2 months (<70), 47.1 months (70-80), and 40.7 months (≥80). Five-year RS was 51.8 %, 57.9 %, and 64.0 %, respectively. In multivariable analysis, age 70-80 (aHR 1.20) and ≥80 (aHR 1.50) were associated with worse OS. Other independent risk factors included Charlson score ≥2, ASA ≥3, >3 CRLM, largest CRLM >4 cm, synchronous or extrahepatic disease, and major complications. CONCLUSION: Resection of CRLM in selected elderly patients results in acceptable overall survival.
Source: HPB
Authors: Victor van Woerden, Michelle R. de Graaff, Arthur K.E. Elfrink, Dirk J. Grünhagen, Niels F.M. Kok, Steven W.M. Olde Damink, Ronald M. van Dam, Joost M. Klaase, Carlijn I. Buis, Jeroen Hagendoorn, Cornelis Verhoef, Henk H. Hartgrink, Rutger-Jan Swijnenburg, Joris Erdmann, Peter B. van den Boezem, Paul D. Gobardhan, Hans Torrenga, Mike S.L. Liem, Wouter K.G. Leclercq, Koop Bosscha, Eric J.T. Belt, Maarten Vermaas, Koert F.D. Kuhlmann, Hendrik A. Marsman, Gijsbert A. Patijn, Marcel den Dulk, Steven J. Oosterling
Institutions: Maastricht University Medical Centre, Albert Schweitzer Ziekenhuis, Dutch Institute for Clinical Auditing, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Erasmus MC, Erasmus MC Cancer Institute, The Netherlands Cancer Institute, Essen University Hospital, University Medical Center Groningen, University Medical Center Utrecht, St. Antonius Ziekenhuis, Leiden University, Leiden University Medical Center, Cancer Center Amsterdam, Radboud University Nijmegen, Radboud University Medical Center, Amphia Ziekenhuis, Deventer Ziekenhuis, Medisch Spectrum Twente, Máxima Medisch Centrum, Jeroen Bosch Ziekenhuis, IJsselland Ziekenhuis, OLVG, Isala, Spaarne Gasthuis
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,100
OpenAlex ID: W4416827279