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This retrospective review assessed the safety and validity of elective hepatic resection for cancer in patients > or = 65 years of age. Fifty-two patients (31M; 21F; mean age: 70 +/- 5 years; range: 65-82) > or = 65 years of age underwent hepatic resection for cancer between January 1992 and May 1999). The overall preoperative mortality rate was 8%. The mean hospital stay was 23 +/- 10 days (range: 6-45 days), and admission to the intensive care unit was required for only 1 patient. By univariate analysis, preoperative jaundice (p = 0.03), length of surgery (> or = 240 min.) (p = 0.006), preoperative blood transfusions (> or = 500 cc) (p = 0.001), and extent of hepatic resection (p = 0.01), were predictors of postoperative complications. In a multivariate analysis only preoperative blood transfusions predicted complications (p = 0.01). When outcome was compared with that in 65 patients younger than 65 years of age who had hepatic resection for cancer during the same period, there were no difference in terms of morbidity, mortality, and mean hospital stay The 1-, 3-, and 5-year survival rate for patients > or = 65 years of age and for patients < 65 years of age were 89%, 61%, and 45%, and 87%, 46% and 39% respectively. Hepatic resections can be performed for the elderly with acceptable morbidity and mortality rates and possible long-term survival. Chronological age alone is not a contraindication to liver surgery for malignancies.

The purpose of this perspective study was to evaluate which prognostic factors predict long-term survival and disease-free survival (DFS) of elderly patients (> or = 65 years) who underwent surgery for colorectal carcinoma. Between January 1992 and December 1998, 196 colorectal cancer patients > or = 65 years (114 M; 82 F; mean age: 75 years; range: 65-92) underwent surgery. One hundred forty-five (74%) of them underwent curative surgery and emergency surgery was more common in patients > or = 75 years of age than among those younger than 75 years (39% vs 23%; p = 0.01). The overall peroperative mortality rate was 3% (n = 6). The median length of hospital stay was 18 days (range: 3-86 days). By univariate analysis, intraoperative bleeding (> or = 500 cc; p = 0.002), length of surgery (> or = 240 min.; p = 0.004), and rectal cancer (p = 0.0001) were associated with complications. By multivariate analysis, only rectal cancer (p = 0.002) was associated with complications. The overall 1, 3-, and 5-year survival rate and DFS rate were 97%, 82%, 74%, and 86%, 64% and 60% respectively. Using multivariate analysis only tumour stage (p < 0.0001) and peroperative blood transfusions (> or = 500 cc; p = 0.006) were associated with outcome. Treatment decisions in elderly patients with colorectal carcinoma should not be influenced by the chronologic age of the patient.