Hepatectomy in Elderly Patients: Does Age Matter?
Background With the increase in average life expectancy in recent decades, the proportion of elderly patients requiring liver surgery is rising. The aim of the meta-analysis reported here was to evaluate the safety and efficacy of hepatectomy in elderly patients. Methods An extensive electronic sear...
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| Veröffentlicht in: | World journal of surgery 2013-12, Vol.37 (12), p.2899-2910 |
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| creator | Zhou, Yanming Zhang, Xiaofeng Zhang, Zuobing Liu, Xiaobin Wu, Lupeng Li, Yumin Li, Bin |
| description | Background
With the increase in average life expectancy in recent decades, the proportion of elderly patients requiring liver surgery is rising. The aim of the meta-analysis reported here was to evaluate the safety and efficacy of hepatectomy in elderly patients.
Methods
An extensive electronic search was performed for relevant articles that compare the outcomes of hepatectomy in patients ≥70 years of age with those in younger patients prior to October 2012. Analysis of pooled data was performed with RevMan 5.0.
Results
Twenty-eight observational studies involving 15,480 patients were included in the analysis. Compared with the younger patients, elderly patients experienced more complications (31.8 vs 28.7 %;
P
= 0.002), mainly as a result of increased cardiac complications (7.5 vs 1.9 %;
P
|
| doi_str_mv | 10.1007/s00268-013-2184-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1490735712</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3124825041</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4884-57c89ce2cc1749a8090e0dbf5b108ad6c0f3103ba525fe64218e9c8f8aed20013</originalsourceid><addsrcrecordid>eNqFkEFLwzAYhoMobk5_gBcpePFS_ZK0aeNF5tycMlFQ8Riy9Ovo6NqZdMj-vRmdIoJ4Sg7P8-bNS8gxhXMKkFw4ACbSECgPGU2jMN4hXRpxFjLO-C7pAheRv1PeIQfOzQFoIkDskw7jMpacyy6hY1zqBk1TL9ZBUQXDMkNbroMn3RRYNe4yuKnRBf0ZBg-6adBeHZK9XJcOj7Znj7yOhi-DcTh5vL0b9CehidJNl8Sk0iAzhiaR1ClIQMimeTylkOpMGMg5BT7VMYtzFJH_AEqT5qnGjPmmvEfO2tylrd9X6Bq1KJzBstQV1iunaCQh4XFCmUdPf6HzemUr385TMVDBQMSeoi1lbO2cxVwtbbHQdq0oqM2eqt1T-cfVZk-1cU62yavpArNv42tAD8gW-ChKXP-fqN7un69HIARE3mWt67xWzdD-qP1no09DGI3b</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1450162065</pqid></control><display><type>article</type><title>Hepatectomy in Elderly Patients: Does Age Matter?</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals</source><creator>Zhou, Yanming ; Zhang, Xiaofeng ; Zhang, Zuobing ; Liu, Xiaobin ; Wu, Lupeng ; Li, Yumin ; Li, Bin</creator><creatorcontrib>Zhou, Yanming ; Zhang, Xiaofeng ; Zhang, Zuobing ; Liu, Xiaobin ; Wu, Lupeng ; Li, Yumin ; Li, Bin</creatorcontrib><description>Background
With the increase in average life expectancy in recent decades, the proportion of elderly patients requiring liver surgery is rising. The aim of the meta-analysis reported here was to evaluate the safety and efficacy of hepatectomy in elderly patients.
Methods
An extensive electronic search was performed for relevant articles that compare the outcomes of hepatectomy in patients ≥70 years of age with those in younger patients prior to October 2012. Analysis of pooled data was performed with RevMan 5.0.
Results
Twenty-eight observational studies involving 15,480 patients were included in the analysis. Compared with the younger patients, elderly patients experienced more complications (31.8 vs 28.7 %;
P
= 0.002), mainly as a result of increased cardiac complications (7.5 vs 1.9 %;
P
< 0.001) and delirium (11.7 vs 4.5 %;
P
< 0.001). Postoperative major surgical complications (12.6 vs 11.3 %;
P
= 0.55) and mortality (3.6 vs 3.3 %;
P
= 0.68) were comparable between elderly and younger patients. For patients with malignancies, both the 5-year disease-free survival (26.5 vs 26.3 %;
P
= 0.60) and overall survival (39.5 vs 40.7 %;
P
= 0.29) did not differ significantly between the two groups.
Conclusions
Postoperative major surgical complications, mortality, and long-term results in elderly patients seem to be comparable with those in younger patients, suggesting that age alone should not be considered a contraindication for hepatectomy.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-013-2184-5</identifier><identifier>PMID: 23959339</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Abdominal Surgery ; Age Factors ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - surgery ; Cardiac Surgery ; Colorectal Liver Metastasis ; Disease-Free Survival ; General Surgery ; Hepatectomy - mortality ; Hepatic Resection ; Humans ; Liver Neoplasms - mortality ; Liver Neoplasms - secondary ; Liver Neoplasms - surgery ; Liver Resection ; Medicine ; Medicine & Public Health ; Models, Statistical ; Postoperative Complications - etiology ; Postoperative Complications - mortality ; Surgery ; Survival Rate ; Thoracic Surgery ; Treatment Outcome ; Vascular Surgery ; Weighted Mean Difference ; Young Group</subject><ispartof>World journal of surgery, 2013-12, Vol.37 (12), p.2899-2910</ispartof><rights>Société Internationale de Chirurgie 2013</rights><rights>2013 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4884-57c89ce2cc1749a8090e0dbf5b108ad6c0f3103ba525fe64218e9c8f8aed20013</citedby><cites>FETCH-LOGICAL-c4884-57c89ce2cc1749a8090e0dbf5b108ad6c0f3103ba525fe64218e9c8f8aed20013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-013-2184-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-013-2184-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,41464,42533,45550,45551,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23959339$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Yanming</creatorcontrib><creatorcontrib>Zhang, Xiaofeng</creatorcontrib><creatorcontrib>Zhang, Zuobing</creatorcontrib><creatorcontrib>Liu, Xiaobin</creatorcontrib><creatorcontrib>Wu, Lupeng</creatorcontrib><creatorcontrib>Li, Yumin</creatorcontrib><creatorcontrib>Li, Bin</creatorcontrib><title>Hepatectomy in Elderly Patients: Does Age Matter?</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
With the increase in average life expectancy in recent decades, the proportion of elderly patients requiring liver surgery is rising. The aim of the meta-analysis reported here was to evaluate the safety and efficacy of hepatectomy in elderly patients.
Methods
An extensive electronic search was performed for relevant articles that compare the outcomes of hepatectomy in patients ≥70 years of age with those in younger patients prior to October 2012. Analysis of pooled data was performed with RevMan 5.0.
Results
Twenty-eight observational studies involving 15,480 patients were included in the analysis. Compared with the younger patients, elderly patients experienced more complications (31.8 vs 28.7 %;
P
= 0.002), mainly as a result of increased cardiac complications (7.5 vs 1.9 %;
P
< 0.001) and delirium (11.7 vs 4.5 %;
P
< 0.001). Postoperative major surgical complications (12.6 vs 11.3 %;
P
= 0.55) and mortality (3.6 vs 3.3 %;
P
= 0.68) were comparable between elderly and younger patients. For patients with malignancies, both the 5-year disease-free survival (26.5 vs 26.3 %;
P
= 0.60) and overall survival (39.5 vs 40.7 %;
P
= 0.29) did not differ significantly between the two groups.
Conclusions
Postoperative major surgical complications, mortality, and long-term results in elderly patients seem to be comparable with those in younger patients, suggesting that age alone should not be considered a contraindication for hepatectomy.</description><subject>Abdominal Surgery</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Cardiac Surgery</subject><subject>Colorectal Liver Metastasis</subject><subject>Disease-Free Survival</subject><subject>General Surgery</subject><subject>Hepatectomy - mortality</subject><subject>Hepatic Resection</subject><subject>Humans</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - secondary</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver Resection</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Models, Statistical</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - mortality</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Thoracic Surgery</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><subject>Weighted Mean Difference</subject><subject>Young Group</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkEFLwzAYhoMobk5_gBcpePFS_ZK0aeNF5tycMlFQ8Riy9Ovo6NqZdMj-vRmdIoJ4Sg7P8-bNS8gxhXMKkFw4ACbSECgPGU2jMN4hXRpxFjLO-C7pAheRv1PeIQfOzQFoIkDskw7jMpacyy6hY1zqBk1TL9ZBUQXDMkNbroMn3RRYNe4yuKnRBf0ZBg-6adBeHZK9XJcOj7Znj7yOhi-DcTh5vL0b9CehidJNl8Sk0iAzhiaR1ClIQMimeTylkOpMGMg5BT7VMYtzFJH_AEqT5qnGjPmmvEfO2tylrd9X6Bq1KJzBstQV1iunaCQh4XFCmUdPf6HzemUr385TMVDBQMSeoi1lbO2cxVwtbbHQdq0oqM2eqt1T-cfVZk-1cU62yavpArNv42tAD8gW-ChKXP-fqN7un69HIARE3mWt67xWzdD-qP1no09DGI3b</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Zhou, Yanming</creator><creator>Zhang, Xiaofeng</creator><creator>Zhang, Zuobing</creator><creator>Liu, Xiaobin</creator><creator>Wu, Lupeng</creator><creator>Li, Yumin</creator><creator>Li, Bin</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>201312</creationdate><title>Hepatectomy in Elderly Patients: Does Age Matter?</title><author>Zhou, Yanming ; Zhang, Xiaofeng ; Zhang, Zuobing ; Liu, Xiaobin ; Wu, Lupeng ; Li, Yumin ; Li, Bin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4884-57c89ce2cc1749a8090e0dbf5b108ad6c0f3103ba525fe64218e9c8f8aed20013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abdominal Surgery</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Cardiac Surgery</topic><topic>Colorectal Liver Metastasis</topic><topic>Disease-Free Survival</topic><topic>General Surgery</topic><topic>Hepatectomy - mortality</topic><topic>Hepatic Resection</topic><topic>Humans</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - secondary</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver Resection</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Models, Statistical</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - mortality</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>Thoracic Surgery</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><topic>Weighted Mean Difference</topic><topic>Young Group</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Yanming</creatorcontrib><creatorcontrib>Zhang, Xiaofeng</creatorcontrib><creatorcontrib>Zhang, Zuobing</creatorcontrib><creatorcontrib>Liu, Xiaobin</creatorcontrib><creatorcontrib>Wu, Lupeng</creatorcontrib><creatorcontrib>Li, Yumin</creatorcontrib><creatorcontrib>Li, Bin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Yanming</au><au>Zhang, Xiaofeng</au><au>Zhang, Zuobing</au><au>Liu, Xiaobin</au><au>Wu, Lupeng</au><au>Li, Yumin</au><au>Li, Bin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatectomy in Elderly Patients: Does Age Matter?</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2013-12</date><risdate>2013</risdate><volume>37</volume><issue>12</issue><spage>2899</spage><epage>2910</epage><pages>2899-2910</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
With the increase in average life expectancy in recent decades, the proportion of elderly patients requiring liver surgery is rising. The aim of the meta-analysis reported here was to evaluate the safety and efficacy of hepatectomy in elderly patients.
Methods
An extensive electronic search was performed for relevant articles that compare the outcomes of hepatectomy in patients ≥70 years of age with those in younger patients prior to October 2012. Analysis of pooled data was performed with RevMan 5.0.
Results
Twenty-eight observational studies involving 15,480 patients were included in the analysis. Compared with the younger patients, elderly patients experienced more complications (31.8 vs 28.7 %;
P
= 0.002), mainly as a result of increased cardiac complications (7.5 vs 1.9 %;
P
< 0.001) and delirium (11.7 vs 4.5 %;
P
< 0.001). Postoperative major surgical complications (12.6 vs 11.3 %;
P
= 0.55) and mortality (3.6 vs 3.3 %;
P
= 0.68) were comparable between elderly and younger patients. For patients with malignancies, both the 5-year disease-free survival (26.5 vs 26.3 %;
P
= 0.60) and overall survival (39.5 vs 40.7 %;
P
= 0.29) did not differ significantly between the two groups.
Conclusions
Postoperative major surgical complications, mortality, and long-term results in elderly patients seem to be comparable with those in younger patients, suggesting that age alone should not be considered a contraindication for hepatectomy.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23959339</pmid><doi>10.1007/s00268-013-2184-5</doi><tpages>12</tpages></addata></record> |
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| ispartof | World journal of surgery, 2013-12, Vol.37 (12), p.2899-2910 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals |
| subjects | Abdominal Surgery Age Factors Aged Aged, 80 and over Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - surgery Cardiac Surgery Colorectal Liver Metastasis Disease-Free Survival General Surgery Hepatectomy - mortality Hepatic Resection Humans Liver Neoplasms - mortality Liver Neoplasms - secondary Liver Neoplasms - surgery Liver Resection Medicine Medicine & Public Health Models, Statistical Postoperative Complications - etiology Postoperative Complications - mortality Surgery Survival Rate Thoracic Surgery Treatment Outcome Vascular Surgery Weighted Mean Difference Young Group |
| title | Hepatectomy in Elderly Patients: Does Age Matter? |
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