Short- and long-term outcomes of laparoscopic hepatectomy for colorectal liver metastases in elderly patients

Figures & data

Table 1 Baseline characteristics of the two groups

Characteristic	Middle-aged group (n=163)	Elderly group (n=78)	P-value
Age (years)	67 (60–69)	74 (70–78)	0.000
Gender			0.616
Male	114	57
Female	49	21
Charlson comorbidity			0.027
index	130	52
≤2	33	26
>2
BMI (kg/m^2)	22 (18–26)	21 (17–25)	0.221
Largest tumor size (cm)	3 (1–5)	2 (1–4)	0.128
Tumor number	2 (1–4)	2 (1–3)	0.200
Tumor laterality			0.584
Left	98	44
Right	65	34
Preoperative CEA level			0.357
<5 ng/mL	65	36
≥5 ng/mL	98	42
Preoperative chemotherapy	118	69	0.005
Initial colorectal cancer			0.271
TNM stage
I	29	18
II	50	25
III	84	35
ASA score			0.000
I	92	21
II	42	33
III	29	24

Abbreviations: ASA, American Society of Anesthesiologists; BMI, body mass index; CEA, carcinoembryonic antigen.

Table 2 Short-term outcomes of the two groups

Outcome	Middle-aged group (n=163)	Elderly group (n=78)	P-value
Surgical procedure			0.576
Left lateral sectionectomy	11	7
Sectionectomy	51	28
Wedge resection	101	43
Operative time (min)	190 (150–290)	180 (160–260)	0.210
Estimated blood loss (mL)	240 (160–410)	260 (180–430)	0.218
Conversion to open surgery	2	6	0.025
Blood transfusion	9	4	0.899
Patients with postoperative 90-day complications	38	21	0.542
Patients with postoperative 90-day major complications	9	5	1.000
Postoperative hospital stay (days)	9 (7–23)	10 (7–32)	0.128
Postoperative 90-day mortality	1	1	1.000
Residual tumor (R0/R1/R2)	163/0/0	78/0/0	1.000
Margin distance (mm)	10 (5–25)	11 (6–28)	0.521

Table 3 The follow-up data of the two groups

Outcome	Middle-aged group (n=163)	Elderly group (n=78)	P-value
Tumor recurrence, n	66	41	0.078
Liver	32	21	0.201
Extrahepatic	25	14	0.607
Both	9	6	0.713
Time to recurrence (median, months)	22 (2–45)	18 (2–42)	0.090
Mortality	53	32	0.196
Died of cancer	48	29	0.228
Died of non-cancer-related diseases	5	3	1.000

Table 4 Univariate Kaplan–Meier analysis of overall survival

Variable	Five-year overall survival	P-value
Age		0.139
60–69 years	59
≥70 years	52
Gender		0.201
Male	58
Female	54
Charlson comorbidity index		0.087
≤2	61
>2	52
ASA score		0.351
I–II	59
III	54
Preoperative CEA level		0.106
<5 ng/mL	61
≥5 ng/mL	49
TNM stage of colorectal cancer		0.007
I–II	68
III	43
Disease-free interval		0.011
<12 months	42
≥12 months	67
Tumor number		0.024
<3	59
≥3	48
Tumor laterality		0.547
Left	56
Right	51

Abbreviations: ASA, American Society of Anesthesiologists; CEA, carcinoembryonic antigen.

Table 5 Cox proportional hazards model for overall survival

Variable	Hazard ratio (95% CI)	P-value
Charlson comorbidity index ≤2 versus >2	1.205 (0.651–1.558)	0.128
TNM stage of colorectal cancer I–II versus III	1.981 (1.258–3.854)	0.021
Disease-free interval ≥12 versus <12 months	1.610 (1.378–2.873)	0.015
Tumor number <3 versus ≥3	1.500 (1.258–1.870)	0.041

Table 6 Univariate Kaplan–Meier analysis of disease-free survival

Variable	Five-year overall survival	P-value
Age		0.090
60–69 years	49
≥70 years	45
Gender		0.210
Male	51
Female	46
Charlson comorbidity index		0.089
≤2	52
>2	44
ASA score		0.181
I–II	51
III	45
Preoperative CEA level		0.021
<5 ng/mL	58
≥5 ng/mL	41
TNM stage of colorectal cancer		0.032
I–II	54
III	46
Disease-free interval		0.008
<12 months	39
≥12 months	59
Tumor number		0.128
<3	51
≥3	44
Tumor laterality		0.224
Left	52
Right	44

Abbreviations: ASA, American Society of Anesthesiologists; CEA, carcinoembryonic antigen; TNM, tumor-node-metastasis.

Table 7 Cox proportional hazards model for disease-free survival

Variables	Hazard ratio (95% CI)	P-value
Age 60–69 versus ≥70 years	1.328 (0.544–1.698)	0.210
Charlson comorbidity index ≤2 versus >2	1.187 (0.749–1.584)	0.267
TNM stage of colorectal cancer I–II versus III	1.415 (0.879–1.874)	0.089
Disease-free interval ≥12 versus <12 months	1.874 (1.215–2.001)	0.036
Preoperative CEA level <5 versus ≥5 ng/mL	1.740 (1.418–2.108)	0.028

Abbreviation: CEA, carcinoembryonic antigen; TNM, tumor-node-metastasis.

Figure 1 Comparison of overall survival rate between elderly and middle-aged groups (P=0.139).

Figure 2 Comparison of disease-free survival rates between elderly and middle-aged groups (P=0.090).