First results from collaboration network in the north-east of the Netherlands.
Author(s): C.I. Buis, C. Hoff, E.R. Manusama, G.A. Patijn, J.I. Erdmann, J. Klaase, J. Sprakel, M.T. de Boer, P. Veldhuis, V.B. Nieuwenhuijs
Introduction:
This study evaluated the outcome of liver surgery in patients over 75 years old in the Managed Clinical Network (MCN) northeast Netherlands, a new national multicentre cooperation.
Patients and Methods:
Within the MCN 4 hospitals (3 tertiary centers and 1 quaternary center) work closely together to assure optimal quality and service for all HPB pathology in the region. We analyzed the results from a prospectively database for the past 3 years since the start of our cooperation.
Results:
From 2012 – 2014 620 patients underwent a liver resection were analyzed. 81 (13%) was over 75 years, this cohort was separately investigated.
The majority (61, 75%) underwent resection for colorectal liver metastasis. 14 elderly patients underwent liver resection for a primary malignancy of the liver.
For the elderly group resected for CRLM 24% was ASA3+. Neoadjuvant chemotherapy was administred in 56%. In 66% one or two lesions were resected and 31% underwent a major resection. Postoperative bile leak percentage was 4%, median length of stay was 7 days. 89% R0 resections were performed and with a median follow up of 19.3 months recurrent disease was seen in 37% of the patients.Survival in the entire elderly group was 100% at 90 days.
Conclusion:
Liver resection within the MCN in the elderly is performed with a perfect survival rate and acceptable morbidity rate. We are encouraged to investigate further our selection process and in-depth the outcome after surgery amongst others the quality of life of the elderly.
