Hepatobiliary Oncologic Surgery in the Elderly

Purpose of Review This review aims to describe the treatment and outcomes in the perioperative management of elderly patients undergoing hepatic surgery for cancer. Recent Findings There is a broad perception that elderly patients are more frail and less able to tolerate major resection. They are therefore offered surgery less often than younger patients. Elderly patients can tolerate major hepatectomies with comparable length of surgery, rate of transfusion, and length of hospital stay as younger patients. However, they are more apt to develop significant cardiopulmonary complications and require discharge to an acute care facility. When matched for tumor stage, disease-specific survival is similar to younger patients. Summary Contrary to what is sometimes perceived, elderly patients can tolerate major hepatic resection. However, this requires careful patient selection and preoperative evaluation, as elderly patients are more prone to complications, concerns related to quality of life outcomes and perioperative mortality.