Introduction: We sought to evaluate the effect of age on postoperative outcomes among patients undergoing major liver surgery for perihilar cholangiocarcinoma (PHCC). Methods: 77 patients were included. Patients were categorized into two groups: the “< 70-year-olds” group (n = 54) and the “≥ 70-year-olds” group (n = 23). Results: Median LOS was 19 both for < 70-year-old group and ≥ 70-year-old group (P = 0.72). No differences in terms of severe complication were detected (44.4% Clavien–Dindo 3–4–5 in < 70-year-old group vs 47.8% in ≥ 70-year-old group, P = 0.60). Within 90 postoperative days, 11 patients died, 6 in < 70-year-old group (11.3%) and 5 in ≥ 70-year-old group (21.7%), P = 0.29. The median follow‐up was 20 months. The death rate was 72.2% and 78.3% among patients < 70 years old and ≥ 70 years old. The OS at 2 and 5 years was significantly higher among the < 70 years old (57.0% and 27.7%) compared to the ≥ 70 years old (27.1% and 13.6%), P = 0.043. Adjusting for hypertension and Charlson comorbidity index in a multivariate analysis, the HR for age was 1.93 (95% CI 0.84–4.44), P = 0.12. Relapse occurred in 43 (81.1%) patients in the < 70-year-old group and in 19 (82.6%) patients in the ≥ 70-year-old group. DFS at 12, 24, and 36 months was, respectively, 59.6, 34.2, and 23.2 for the < 70 -year-old group and 32.5, 20.3, and 13.5 for the ≥ 70-year-old group (P = 0.26). Adjusting for hypertension and Charlson comorbidity index in a Cox model, the HR for age was 1.52 (95% CI 0.67–3.46), with P = 0.32. Conclusions: ≥ 70-year-old patients with PHCC can still be eligible for major liver resection with acceptable complication rates and should not be precluded a priori from a radical treatment.

Ripamonti, L., De Carlis, R., Lauterio, A., Mangoni, I., Frassoni, S., Bagnardi, V., et al. (2022). Major hepatectomy for perihilar cholangiocarcinoma in elderly patients: is it reasonable?. UPDATES IN SURGERY, 74(1), 203-211 [10.1007/s13304-021-01111-6].

Major hepatectomy for perihilar cholangiocarcinoma in elderly patients: is it reasonable?

Lauterio A.;Frassoni S.;Bagnardi V.;De Carlis L.
2022

Abstract

Introduction: We sought to evaluate the effect of age on postoperative outcomes among patients undergoing major liver surgery for perihilar cholangiocarcinoma (PHCC). Methods: 77 patients were included. Patients were categorized into two groups: the “< 70-year-olds” group (n = 54) and the “≥ 70-year-olds” group (n = 23). Results: Median LOS was 19 both for < 70-year-old group and ≥ 70-year-old group (P = 0.72). No differences in terms of severe complication were detected (44.4% Clavien–Dindo 3–4–5 in < 70-year-old group vs 47.8% in ≥ 70-year-old group, P = 0.60). Within 90 postoperative days, 11 patients died, 6 in < 70-year-old group (11.3%) and 5 in ≥ 70-year-old group (21.7%), P = 0.29. The median follow‐up was 20 months. The death rate was 72.2% and 78.3% among patients < 70 years old and ≥ 70 years old. The OS at 2 and 5 years was significantly higher among the < 70 years old (57.0% and 27.7%) compared to the ≥ 70 years old (27.1% and 13.6%), P = 0.043. Adjusting for hypertension and Charlson comorbidity index in a multivariate analysis, the HR for age was 1.93 (95% CI 0.84–4.44), P = 0.12. Relapse occurred in 43 (81.1%) patients in the < 70-year-old group and in 19 (82.6%) patients in the ≥ 70-year-old group. DFS at 12, 24, and 36 months was, respectively, 59.6, 34.2, and 23.2 for the < 70 -year-old group and 32.5, 20.3, and 13.5 for the ≥ 70-year-old group (P = 0.26). Adjusting for hypertension and Charlson comorbidity index in a Cox model, the HR for age was 1.52 (95% CI 0.67–3.46), with P = 0.32. Conclusions: ≥ 70-year-old patients with PHCC can still be eligible for major liver resection with acceptable complication rates and should not be precluded a priori from a radical treatment.
No
Articolo in rivista - Articolo scientifico
Scientifica
Cholangiocarcinoma; Elderly; Hepatectomy; Klatskin; Liver; Perihilar;
English
203
211
9
Ripamonti, L., De Carlis, R., Lauterio, A., Mangoni, I., Frassoni, S., Bagnardi, V., et al. (2022). Major hepatectomy for perihilar cholangiocarcinoma in elderly patients: is it reasonable?. UPDATES IN SURGERY, 74(1), 203-211 [10.1007/s13304-021-01111-6].
Ripamonti, L; De Carlis, R; Lauterio, A; Mangoni, I; Frassoni, S; Bagnardi, V; Centonze, L; Poli, C; Buscemi, V; Ferla, F; De Carlis, L
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/320612
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