Major liver resections for primary liver malignancies in the elderly

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Geriatric surgery

Background:

• Primary liver tumors pose a significant challenge, particularly in elderly patients.
• Surgical resection is a primary treatment modality for liver malignancies.
• Outcomes of major hepatic resections in patients aged 75 years and older require careful evaluation.

Purpose of the Study:

• To prospectively assess the outcomes of major hepatic resections for primary liver tumors.
• To evaluate the safety and efficacy of liver resections in patients aged 75 years and older.

Main Methods:

• Prospective data collection from 1999 to 2006 for 23 patients (≥75 years) with primary liver malignancies.
• Patients underwent curative resection for primary liver malignancies in non-cirrhotic livers.
• Patients were categorized into two groups: resectable (Group A) and unresectable (Group B) tumors.

Main Results:

• The study included 14 intrahepatic cholangiocarcinoma and 9 hepatocellular carcinoma cases, all with comorbidities.
• Group A (resectable) had morbidity and mortality rates of 25% and 8%, respectively.
• Group A demonstrated 1-, 2-, and 3-year survival rates of 71%, 51%, 26% (cholangiocarcinoma) and 80%, 60%, 60% (hepatocellular carcinoma), contrasting with Group B's survival rates of 45%, 18%, and 0%.

Conclusions:

• Advanced age (≥75 years) does not appear to be a negative prognostic factor for liver resections.
• Hepatic resections in elderly patients (≥75 years) can be performed with acceptable safety and outcomes.
• Appropriate patient selection is crucial for successful major hepatic resections in the elderly population.