Clinical efficacy of liver resection for colorectal liver metastasis in the elderly and prognosis factor analysis / 中华老年医学杂志

ABSTRACT

Objective:To investigate the clinical efficacy of liver resection for colorectal liver metastases(CRLM)in elderly patients and to analyze factors influencing prognosis.Methods:Clinicopathological and follow-up data of 476 CRLM patients undergone liver resection at our department between January 2000 and August 2016 were retrospectively analyzed.Patients were divided into two groups according their ages: the elderly group(n=112, aged 65 years or older)and the young and middle-aged group(n=364, aged less than 65 years). The safety of the surgical treatment and long-term survival were compared between the two groups.Results:The overall postoperative complication rate was 30.3%.There was no significant difference in postoperative complication rates between the elderly group and the young and middle-aged group(32.1% vs. 29.7%, P=0.618). The mortality within 90 days after surgery was 0.9% in the elderly group and 0.5% in the young and middle-aged group( P=0.688). The 5-year survival rates after surgery were similar between the elderly group and the young and middle-aged group(42.4% vs.44.3%, P=0.672). Multivariate analysis revealed that clinical risk score(CRS)≥3 and RAS mutation were independent risk factors for prognosis. Conclusions:Liver resection is safe in carefully selected elderly CRLM patients and can achieve good long-term outcomes.The CRS and RAS genotype can help predict prognosis in elderly CRLM patients.