Immediate results of surgical treatment of peripheral hepatic cholangiocarcinoma in elderly and senile patients
Objective. To estimate immediate results of surgical treatment of peripheral cholangiocarcinoma in elderly and senile patients.
Materials and methods. In 2004-2018 yrs period in the Department of Transplantation and Surgery of the Liver of the Shalimov National Institute of Surgery and Transplantology 84 patients, suffering peripheral cholangiocarcinoma, were radically operated: 31 (36.9%) patients older than 60 yrs (the main Group), and 53 (63.1%) patients, younger than 60 yrs (control Group).
Results. Postoperative clinically significant (IIIa-IV degree in accordance to classification of Clavien-Dindo) complications during 90-days of postoperative period were noted in 29.1% patients of the main Group and in 32.1% patients of a control Group (p=0.262), postoperative hepatic insufficiency, in accordance to The International Study Group of Liver Surgery criteria, - in 16.1 and 22.6% accordingly (p=0.473); reoperation was performed in 9.6 and 9.4% patients, accordingly (p=0.973). The causes of postoperative lethality in 2 patients of the main Group were an acute myocardial infarction (1) and an acute pulmonary thromboembolism (1).
Conclusion. Hepatic resection is characterized by satisfactory immediate results of treatment of peripheral cholangiocarcinoma in elderly and senile patients, if performed in highly-specialized multidisciplinary centre and thorough selection of patients.
Lendoire JC, Gil L, Imventarza O. Intrahepatic cholangiocarcinoma surgery: the impact of lymphadenectomy. Chin Clin Oncol. 2018 Oct;7(5):53. doi: 10.21037/cco.2018.07.02. Epub 2018 Jul 17. PMID: 30180752.
Bergquist A, von Seth E. Epidemiology of cholangiocarcinoma. Best Pract Res Clin Gastroenterol. 2015 Apr;29(2):221-32. doi:10.1016/j.bpg.2015.02.003. PubMed PMID: 25966423.
Dedinská I, Laca L, Miklušica J, Palkoci B, Skálová P, Lauková S, et al. Complications of liver resection in geriatric patients. Ann Hepatol. 2017 Jan-Feb;16(1):149-56. doi: 10.5604/16652681.1226934. PMID: 28051804.
Bartsch F, Baumgart J, Tripke V, Hoppe-Lotichius M, Heinrich S, Lang H. Resection of intrahepatic cholangiocarcinoma in elderly patients - is it reasonable? BMC Surg. 2019 Oct 29;19(1):157. doi: 10.1186/s12893-019-0620-7. PMID: 31664988; PMCID: PMC6819605.
Vitale A, Spolverato G, Bagante F, Gani F, Popescu I, Marques HP, et al. A multi-institutional analysis of elderly patients undergoing a liver resection for intrahepatic cholangiocarcinoma. J Surg Oncol. 2016 Mar;113(4):420-6. doi: 10.1002/jso.24148. Epub 2016 Jan 12. PMID: 27100027.
Aapro MS, Köhne CH, Cohen HJ, Extermann M. Never too old? Age should not be a barrier to enrollment in cancer clinical trials. Oncologist. 2005 Mar;10(3):198-204. doi: 10.1634/theoncologist.10-3-198. PMID: 15793223.
Mirici-Cappa F, Gramenzi A, Santi V, Zambruni A, Di Micoli A, Frigerio M, et al. Treatments for hepatocellular carcinoma in elderly patients are as effective as in younger patients: a 20-year multicentre experience. Gut. 2010 Mar;59(3):387-96. doi: 10.1136/gut.2009.194217. PMID: 20207642.
Adam R, Frilling A, Elias D, Laurent C, Ramos E, Capussotti L, Poston GJ, Wicherts DA, de Haas RJ; LiverMetSurvey Centres. Liver resection of colorectal metastases in elderly patients. Br J Surg. 2010 Mar;97(3):366-76. doi: 10.1002/bjs.6889. PMID: 20101645.
Spolverato G, Kim Y, Alexandrescu S, Popescu I, Marques HP, Aldrighetti L, et al. Is Hepatic Resection for Large or Multifocal Intrahepatic Cholangiocarcinoma Justified? Results from a Multi-Institutional Collaboration. Ann Surg Oncol. 2015 Jul;22(7):2218-25. doi: 10.1245/s10434-014-4223-3. Epub 2014 Oct 30. PMID: 25354576; PMCID: PMC4834710.
Lewis AR, Cipriano C, Wang X, Ward R, Fitzpatrick A, Scott ARM, et al. Outcomes in patients ≥ 80 years with a diagnosis of a hepatopancreaticobiliary (HPB) malignancy. Med Oncol. 2019 Sep 6;36(10):85. doi: 10.1007/s12032-019-1310-0. PMID: 31493088.
This work is licensed under a Creative Commons Attribution 4.0 International License.