Liver Resection of Colorectal Metastases in Elderly Patients
The ageing population, the specific epidemiology of colorectal cancer (CRC) and the high incidence of colorectal liver metastases (CRLM) have all led to a significant increase in elderly patients with CRLM seeking surgical management. Due to physiological and functional changes with advancing age (which may decrease the ability of the elderly to sustain aggressive treatment) and the lack of validated guidelines, surgeons still hesitate to plan surgical resection of CRLM in the elderly. Recently, a few studies have suggested that resection of CRLM in the elderly is feasible and yields good short- and long-term outcomes in the context of an intention-to-treat strategy. This article discusses the relevant literature and tries to put forth possible recommendations for the surgical management of elderly patients with CRLM. No chronological upper age limit should contraindicate curative treatment and well-selected elderly patients with advanced CRC can be offered a similar chance of long-term survival with the use of an optimal onco-surgical strategy.