Liver resection in octogenarians: are the outcomes worth the risk?

Australian life expectancy is high by world standards, largely because of advanced health care. It is therefore important to determine safety and oncological benefits of major surgical procedures in the elderly. This retrospective review examines outcomes of liver resection in octogenarians.

Data on all liver resections performed at The Queen Elizabeth Hospital were collected in a prospective database. The primary aim was to determine overall and disease-free survival, and secondary aim to assess perioperative quality of life (QoL) and functionality outcomes using surrogate markers.

Twenty-four octogenarians underwent 26 liver resections for colorectal liver metastases (n = 20), hepatocellular carcinoma (n = 4), cholangiocarcinoma (n = 1) and benign lesion (n = 1). Median hospital stay was 11 days. There were no major post-operative complications and only one patient experienced a decline in QoL. There was no 90-day mortality. Five-year overall survival and 5-year disease-free survival were 47% and 37%, respectively. Median duration of follow-up was 34 months.

Liver resection can be performed safely in octogenarians with low morbidity, excellent overall survival and good QoL outcomes.