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Benign and Malignant Tumors of the Liver

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Principles and Practice of Geriatric Surgery

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Abstract

As the population ages, mortality from cancer has increased, and increasingly cancers of the liver are being encountered in an older population both in the USA and worldwide. The most commonly encountered primary tumor is hepatocellular carcinoma, and the most commonly encountered metastatic tumor is of colorectal origin. Evaluating elderly patients for surgical management involves assessment of their preoperative function, both with overall physiology and evaluation of the liver itself. Prehabilitation regimens to optimize the patient are being promoted, and assessment of the aging liver for cirrhosis and regenerative capability needs to be assessed or even augmented. Benign tumors in otherwise asymptomatic patients rarely require intervention and are usually observed. Malignant tumors are managed with multiple modalities including surgical resection or transplantation, liver-directed therapies such as ablation or hepatic artery embolization, as well as chemotherapy or biologic therapy targeting the relevant tumor type. Data is conflicted, regarding outcomes of performing complex hepatobiliary surgery in the elderly, but overall advancing age in a patient with appropriate physiological and liver reserve should not preclude surgery.

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  1. Department of Surgery, University California San Diego Medical Center, 3855 Health Sciences Drive, Mail Code 0987, La Jolla, CA, 92093, USA

    Rebekah R. White & Vijay G. Menon

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  2. Vijay G. Menon
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Correspondence to Rebekah R. White .

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  1. Surgical Service, Yale University School of Medicine VA Connecticut Health Care System, West Haven, Connecticut, USA

    Ronnie A. Rosenthal

  2. SUNY Downstate School of Public Health, National Capital Region Johns Hopkins Medicine, Bethesda, Maryland, USA

    Michael E. Zenilman

  3. Center for Geriatric Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland, USA

    Mark R. Katlic

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  1. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA

    Jason Johanning

  2. Duke Medicine, Durham, NC, USA

    Sandhya Lagoo-Deenadayalan

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White, R.R., Menon, V.G. (2017). Benign and Malignant Tumors of the Liver. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20317-1_57-1

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