Liver resection versus ablation in geriatric populations - Does one method impart improved in-hospital mortality?
Csaba Gajdos1
, Carrie Ryan1, Goda Savulionyte1, Steven Schwaitzberg1, Nader Nader2
1Department of Surgery, Buffalo University Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA
2Department of Anesthesiology, Buffalo University Jacobs Faculty of Medicine and Biomedical Scinces, Buffalo, USA
Abstract
Objective: This study aimed to compare surgical resection versus ablation for managing liver malignancies in patients 65 and older.
Material and Methods: Cases with liver tumors were extracted from the NSQIP database for patients aged ≥65 years. Following propensity score matching, multivariate Cox regression was used for 30-day morbidity and mortality for liver resection and ablation.
Results: Following a propensity score matching, 1048 patients were 1:1 matched for comorbid conditions. Patients stayed in the hospital three days longer after resection (p<0.001). Mortality was lower after ablation (p= 0.013). This difference was more prominent in patients with primary liver tumors (p= 0.008). Group A had a 10-fold lower risk of developing an abdominal abscess, a fourfold decrease in hospital-associated pneumonia (p= 0.001) and reintubation, a 10-fold reduction in bleeding requiring transfusion (p<0.001), and a three-fold decrease in risk of developing sepsis (p<0.001).
Conclusion: Despite being a generally sicker patient population with worse underlying liver function, ablative techniques were associated with a lower risk of adverse outcomes when compared to more aggressive resection of primary malignant tumors of the liver.
Keywords: Liver cancer, resection, ablation, complications
Cite this article as: Gajdos C, Ryan C, Savulionyte G, Schwaitzberg S, Nader N. Liver resection versus ablation in geriatric populations - Does one method impart improved in-hospital mortality?. Turk J Surg 2024; 40 (1): 47-53.
The research utilized a retrospective cohort study design, drawing data from the American College of Surgeons National Surgical Quality Improvement Program, which is open to the public and the participating institutions. The study uses unidentified information and it was exempted from Institutional Review Board regulation.
Externally peer-reviewed.
Concept - CG, NN; Design - CR, NN; Supervision - , CG, SS; Fundings - SS, NN; Data Collection and/or Processing - GS, NN; Analysis and/or Interpretation - CR, CG, NN; Writing Manuscript - CR, CG, NN; Critical Reviews - CG, SS, NN.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.