Top

Published in:

01-03-2015 | Review Article

The impact of aging on morbidity and mortality after liver resection: a systematic review and meta-analysis

Authors: Toru Mizuguchi, Masaki Kawamoto, Makoto Meguro, Kenji Okita, Shigenori Ota, Masayuki Ishii, Tomomi Ueki, Toshihiko Nishidate, Yasutoshi Kimura, Tomohisa Furuhata, Koichi Hirata

Published in: Surgery Today | Issue 3/2015

Abstract

Surgery involving elderly patients is becoming increasingly common due to the rapid aging of societies all over the world. The objective of this study was to elucidate the prognostic differences between elderly and young patients who undergo liver resection. A systematic review based on the PRISMA flow diagram was conducted. Ovid Medline and PubMed were used to search for relevant literature published between January 2000 and March 2013, and the modified MINORS score was used to assess the methodological quality. In cases of hepatocellular carcinoma and miscellaneous liver tumors, the morbidity and mortality rate did not differ significantly between the elderly and young patients. For patients with colorectal metastatic liver cancer, the mortality of the young patients was 2.7 times lower than that of elderly patients. Our review of high-quality retrospective studies was able to elucidate the clinical risks of age on the outcomes after liver surgery in specific patient populations.

Centers for Disease Control and Prevention (CDC). Trends in aging––US and worldwide. MMWR Morb Mortal Wkly Rep. 2003;52:101–4.

From the Centers for Disease Control and Prevention. Public health and aging: trends in aging––US and worldwide. JAMA. 2003;289:1371–3.CrossRef

Straub RH, Cutolo M, Zietz B, Scholmerich J. The process of aging changes the interplay of the immune, endocrine and nervous systems. Mech Age Dev. 2001;122:1591–611.CrossRef

Nguyen KT, Marsh JW, Tsung A, Steel JJ, Gamblin TC, Geller DA. Comparative benefits of laparoscopic vs open hepatic resection: a critical appraisal. Arch Surg. 2011;146:348–56.CrossRefPubMed

Mizuguchi T, Kawamoto M, Meguro M, Nakamura Y, Ota S, Hui TT, et al. Prognosis and predictors of surgical complications in hepatocellular carcinoma patients with or without cirrhosis after hepatectomy. World J Surg. 2013;37:1379–87.CrossRefPubMed

Nanashima A, Abo T, Hamasaki K, Wakata K, Kunizaki M, Tou K, et al. Predictors of intraoperative blood loss in patients undergoing hepatectomy. Surg Today. 2013;43:485–93.CrossRefPubMed

Shimada H, Tanaka K, Endou I, Ichikawa Y. Treatment for colorectal liver metastases: a review. Langenbecks Arch Surg. 2009;394:973–83.CrossRefPubMed

Cauchy F, Fuks D, Belghiti J. HCC: current surgical treatment concepts. Langenbecks Arch Surg. 2012;397:681–95.CrossRefPubMed

Hanazaki K, Kajikawa S, Shimozawa N, Mihara M, Shimada K, Hiraguri M, et al. Survival and recurrence after hepatic resection of 386 consecutive patients with hepatocellular carcinoma. J Am Coll Surg. 2000;191:381–8.CrossRefPubMed

10.

Ferrero A, Vigano L, Polastri R, Ribero D, Lo Tesoriere R, Muratore A, et al. Hepatectomy as treatment of choice for hepatocellular carcinoma in elderly cirrhotic patients. World J Surg. 2005;29:1101–5.CrossRefPubMed

11.

Huang J, Li BK, Chen GH, Li JQ, Zhang YQ, Li GH, et al. Long-term outcomes and prognostic factors of elderly patients with hepatocellular carcinoma undergoing hepatectomy. J Gastroint Surg. 2009;13:1627–35.CrossRef

12.

Portolani N, Baiocchi GL, Coniglio A, Tiberio GA, Prestini K, Gheza F, et al. Limited liver resection: a good indication for the treatment of hepatocellular carcinoma in elderly patients. Jpn J Clin Oncol. 2011;41:1358–65.CrossRefPubMed

13.

Nagano Y, Nojiri K, Matsuo K, Tanaka K, Togo S, Ike H, et al. The impact of advanced age on hepatic resection of colorectal liver metastases. J Am Coll Surg. 2005;201:511–6.CrossRefPubMed

14.

Mazzoni G, Tocchi A, Miccini M, Bettelli E, Cassini D, De Santis M, et al. Surgical treatment of liver metastases from colorectal cancer in elderly patients. Int J Colorect Dis. 2007;22:77–83.CrossRef

15.

Di Benedetto F, Berretta M, D’Amico G, et al. Liver resection for colorectal metastases in older adults: a paired matched analysis. J Am Geriatr Soc. 2011;59:2282–90.CrossRefPubMed

16.

Cook EJ, Welsh FK, Chandrakumaran K, Montalti R, De Ruvo N, Cautero N, et al. Resection of colorectal liver metastases in the elderly: does age matter? Colorect Dis. 2012;14:1210–6.CrossRef

17.

Mizuguchi T, Kawamoto M, Meguro M, Hui TT, Hirata K. Preoperative liver function assessments to estimate the prognosis and safety of liver resections. Surg Today. 2014;44:1–10.CrossRefPubMed

18.

Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.CrossRefPubMed

19.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.CrossRefPubMedCentralPubMed

20.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.CrossRefPubMedCentralPubMed

21.

Lee CR, Lim JH, Kim SH, Ahn SH, Park YN, Choi GH, et al. A comparative analysis of hepatocellular carcinoma after hepatic resection in young versus elderly patients. J Gastroint Surg. 2012;16:1736–43.CrossRef

22.

Adam R, Frilling A, Elias D, Laurent C, Ramos E, Capussotti L, et al. Liver resection of colorectal metastases in elderly patients. Br J Surg. 2010;97:366–76.CrossRefPubMed

23.

Kulik U, Framke T, Grosshennig A, Ceylan A, Bektas H, Klempnauer J, et al. Liver resection of colorectal liver metastases in elderly patients. World J Surg. 2011;35:2063–72.CrossRefPubMed

24.

Cescon M, Grazi GL, Del Gaudio M, Ercolani G, Ravaioli M, Nardo B, et al. Outcome of right hepatectomies in patients older than 70 years. Arch Surg. 2003;138:547–52.CrossRefPubMed

25.

Menon KV, Al-Mukhtar A, Aldouri A, Prasad RK, Lodge PA, Toogood GJ. Outcomes after major hepatectomy in elderly patients. J Am Coll Surg. 2006;203:677–83.CrossRefPubMed

26.

Shirabe K, Kajiyama K, Harimoto N, Gion T, Tsujita E, Abe T, et al. Early outcome following hepatic resection in patients older than 80 years of age. World J Surg. 2009;33:1927–32.CrossRefPubMed

27.

Reddy SK, Barbas AS, Turley RS, Gamblin TC, Geller DA, Marsh JW, et al. Major liver resection in elderly patients: a multi-institutional analysis. J Am Coll Surg. 2011;212:787–95.CrossRefPubMed

28.

Melloul E, Halkic N, Raptis DA, Tempia A, Demartines N. Right hepatectomy in patients over 70 years of age: an analysis of liver function and outcome. World J Surg. 2012;36:2161–70.CrossRefPubMed

29.

Yeh CN, Lee WC, Jeng LB, Chen MF. Hepatic resection for hepatocellular carcinoma in elderly patients. Hepatogastroenterology. 2004;51:219–23.PubMed

30.

Su CW, Lei HJ, Chau GY, Hung HH, Wu JC, Hsia CY, et al. The effect of age on the long-term prognosis of patients with hepatocellular carcinoma after resection surgery: a propensity score matching analysis. Arch Surg. 2012;147:137–44.CrossRefPubMed

31.

Ettorre GM, Sommacale D, Farges O, Sauvanet A, Guevara O, Belghiti J. Postoperative liver function after elective right hepatectomy in elderly patients. Br J Surg. 2001;88:73–6.CrossRefPubMed

32.

Gruttadauria S, Doria C, Vitale CH, Cintorino D, Foglieni CS, Fung JJ, et al. Preliminary report on surgical technique in hepatic parenchymal transection for liver tumors in the elderly: a lesson learned from living-related liver transplantation. J Surg Oncol. 2004;88:229–33.CrossRefPubMed

33.

Yeh CN, Jan YY, Chen MF. Influence of age on surgical treatment of peripheral cholangiocarcinoma. Am J Surg. 2004;187:559–63.CrossRefPubMed

34.

Aldrighetti L, Arru M, Calori G, Caterini R, Comotti L, Torri G, et al. Impact of age on the outcome of liver resections. Am Surg. 2004;70:453–60.PubMed

35.

Yeh CN, Jan YY, Chen MF. Hepatectomy for peripheral cholangiocarcinoma in elderly patients. Ann Surg Oncol. 2006;13:1553–9.CrossRefPubMed

36.

Caratozzolo E, Massani M, Recordare A, Bonariol L, Baldessin M, Bassi N. Liver resection in elderly: comparative study between younger and older than 70 years patients. Outcomes and implications for therapy. G Chir. 2007;28:419–24.PubMed

37.

Wynne HA, Cope LH, Mutch E, Rawlins MD, Woodhouse KW, James OF. The effect of age upon liver volume and apparent liver blood flow in healthy man. Hepatology. 1989;9:297–301.CrossRefPubMed

38.

Frith J, Jones D, Newton JL. Chronic liver disease in an ageing population. Age Ageing. 2009;38:11–8.CrossRefPubMed

39.

Yoshimura Y, Kubo S, Shirata K, Hirohashi K, Tanaka H, Shuto T, et al. Risk factors for postoperative delirium after liver resection for hepatocellular carcinoma. World J Surg. 2004;28:982–6.CrossRefPubMed

Title: The impact of aging on morbidity and mortality after liver resection: a systematic review and meta-analysis
Authors: Toru Mizuguchi
Masaki Kawamoto
Makoto Meguro
Kenji Okita
Shigenori Ota
Masayuki Ishii
Tomomi Ueki
Toshihiko Nishidate
Yasutoshi Kimura
Tomohisa Furuhata
Koichi Hirata
Publication date: 01-03-2015
Publisher: Springer Japan
Published in: Surgery Today / Issue 3/2015
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-014-0863-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impact of aging on morbidity and mortality after liver resection: a systematic review and meta-analysis

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2015

Clinicopathological features and surgical outcomes of adenosquamous carcinoma of the pancreas: a retrospective analysis of patients with resectable stage tumors

Quinacrine for extremity melanoma in a mouse model of isolated limb perfusion (ILP)

Pancreas-preserving partial duodenectomy of the distal region for large duodenal adenoma: report of a case

Distal migration of a transanastomotic pancreatic stent resulting in bowel perforation 19 years after pancreatoduodenectomy: report of a case

Carotid endarterectomy using a “home-constructed” shunt for patients intolerant to cross-clamping

Systemic control and evaluation of the response to neoadjuvant chemotherapy in resectable thoracic esophageal squamous cell carcinoma with 18F-fluorodeoxyglucose positron emission tomography-positive lymph nodes