Oncological liver resection in elderly - A retrospective comparative study

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BACKGROUND: Due to demographic changes and higher life expectancy especially in industrial nations, the number of liver resections in patients ≥70 years is rising. It is known that older age is associated with higher postoperative morbidity and mortality after surgery under general anesthesia. The aim of this analysis is to compare the postoperative outcome after liver resections for malignancies in patients aged below and above 70 years.

MATERIALS AND METHODS: A prospectively collected electronic database of 1034 liver resections between January 2013 and December 2019 was retrospectively analyzed. Comparative analysis of patients <70 and ≥ 70 years receiving liver resections for malignancies included 889 operations in 703 patients. Analysis of postoperative outcome and uni- and multivariate analyses of associated risk factors were performed.

RESULTS: Median age of the whole cohort was 65 years (range 18-87 years). N = 582 liver resections (65.7%) were performed in patients <70 years with 42.8% major hepatectomies and n = 307 (34.3%) liver resections in patients ≥70 years with 50.5% major hepatectomies (p = 0.034). Relevant postoperative morbidity of the whole cohort was 27.9%. The 30-day mortality was 3.9% and re-operation rate 14.8%. Patients ≥70 years had significantly higher postoperative morbidity and mortality rates than patients <70 years. Major resections, longer operating time, need of intraoperative transfusions of blood products as well as biliodigestive anastomosis (BDA) and inferior vena cava (IVC) resection were independent risk factors for worse postoperative outcome.

CONCLUSION: Liver resections in patients ≥70 years are associated with a worse postoperative course after. Parenchyma sparing resections should be preferred in those patients.


Original languageEnglish
Article number106729
Pages (from-to)106729
JournalInternational journal of surgery
Early online date26 Jun 2022
Publication statusPublished - Aug 2022

External IDs

Scopus 85132866085
WOS 000835570900019
unpaywall 10.1016/j.ijsu.2022.106729
Mendeley 199f69bf-30a6-3cbb-bc2f-c40b513ff17d
ORCID /0000-0002-7017-3738/work/142254024


Research priority areas of TU Dresden

Subject groups, research areas, subject areas according to Destatis

Sustainable Development Goals

ASJC Scopus subject areas


  • Adolescent, Adult, Aged, Aged, 80 and over, Hepatectomy, Humans, Liver, Liver Neoplasms, Middle Aged, Neoplasms, Retrospective Studies, Treatment Outcome, Vena Cava, Inferior, Young Adult, Mortality, Liver surgery, Morbidity, Risk factors, Elderly