HEPATIC RESECTION FOR MALIGNANCY IN THE ELDERLY

Although elderly patients are accounted for in all large series of maj or hepatic resections, the role of age as a determinant of outcome rem ains unclear. At Cedars-Sinai Medical Center, we review a series of 20 major hepatectomies for neoplasia performed in patients older than 66 years of age (4 of them greater than or equal to 80 years old) over a 5-year period. A retrospective comparison was conducted with a group of 22 hepatectomies for malignancy performed in 20 patients younger th an 59 years of age during the same time period. The younger group had a significantly greater degree of liver resected (12 trisegmentectomie s vs 3). Although one operative death (5% mortality) was observed in t he elderly group, no statistically significant difference was noted, w hen compared to the younger group (Chi-square, P = 0.48). Likewise, no significant difference in the complication rate (20% vs 33%) was noti ced (Chi-square, P = 0.8). Severe postoperative liver dysfunction was present in 2 cases (10%) in the elderly group and one (4%) in the youn ger group. These patients underwent a right trisegmentectomy; (TS). Ni ne patients from each group were resected without red blood cell trans fusion. We conclude that major hepatic resection in elderly patients w ithout severe comorbid disease is a safe procedure that is not associa ted with an increased perioperative morbidity or mortality rate.