Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis
Abstract Background Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients. Methods From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a...
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doaj-6364bae2e5a64b8d89671d33d7ebb5aa2020-11-25T03:40:11ZengBMCWorld Journal of Surgical Oncology1477-78192020-10-0118111310.1186/s12957-020-02055-8Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysisKe-Min Jin0Kun Wang1Quan Bao2Hong-Wei Wang3Bao-Cai Xing4Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Hepatobiliary and Pancreatic Surgery Unit I, Peking University Cancer Hospital & InstituteKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Hepatobiliary and Pancreatic Surgery Unit I, Peking University Cancer Hospital & InstituteKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Hepatobiliary and Pancreatic Surgery Unit I, Peking University Cancer Hospital & InstituteKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Hepatobiliary and Pancreatic Surgery Unit I, Peking University Cancer Hospital & InstituteKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Hepatobiliary and Pancreatic Surgery Unit I, Peking University Cancer Hospital & InstituteAbstract Background Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients. Methods From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥ 70 years of age) were matched to 128 younger patients (< 70 years of age) to obtain two balanced groups with regard to demographic, therapeutic, and prognostic factors. Results There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score III and comorbidities and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p < 0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175 ml vs. 200 ml, p = 0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p = 0.020), and a higher readmission rate (4.7% vs.0%, p = 0.036). The EG also had longer disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p > 0.05). Old age was not an independent factor for DFS, OS, and CSS by Cox multivariate regression analysis (p > 0.05). Conclusions Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS, and CSS.http://link.springer.com/article/10.1186/s12957-020-02055-8Liver-limited metastasesColorectal cancerElderlyHepatectomySurvival |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ke-Min Jin Kun Wang Quan Bao Hong-Wei Wang Bao-Cai Xing |
spellingShingle |
Ke-Min Jin Kun Wang Quan Bao Hong-Wei Wang Bao-Cai Xing Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis World Journal of Surgical Oncology Liver-limited metastases Colorectal cancer Elderly Hepatectomy Survival |
author_facet |
Ke-Min Jin Kun Wang Quan Bao Hong-Wei Wang Bao-Cai Xing |
author_sort |
Ke-Min Jin |
title |
Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis |
title_short |
Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis |
title_full |
Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis |
title_fullStr |
Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis |
title_full_unstemmed |
Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis |
title_sort |
liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis |
publisher |
BMC |
series |
World Journal of Surgical Oncology |
issn |
1477-7819 |
publishDate |
2020-10-01 |
description |
Abstract Background Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients. Methods From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥ 70 years of age) were matched to 128 younger patients (< 70 years of age) to obtain two balanced groups with regard to demographic, therapeutic, and prognostic factors. Results There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score III and comorbidities and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p < 0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175 ml vs. 200 ml, p = 0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p = 0.020), and a higher readmission rate (4.7% vs.0%, p = 0.036). The EG also had longer disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p > 0.05). Old age was not an independent factor for DFS, OS, and CSS by Cox multivariate regression analysis (p > 0.05). Conclusions Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS, and CSS. |
topic |
Liver-limited metastases Colorectal cancer Elderly Hepatectomy Survival |
url |
http://link.springer.com/article/10.1186/s12957-020-02055-8 |
work_keys_str_mv |
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