Ann Surg Treat Res.  2020 Jan;98(1):7-14. 10.4174/astr.2020.98.1.7.

Short- and long-term outcomes of pancreaticoduodenectomy in elderly patients with periampullary cancer

Affiliations
  • 1Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 2Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Korea. sunkim@snu.ac.kr

Abstract

PURPOSE
Pancreaticoduodenectomy (PD) is recently performed in older cancer patients. The complication rate of PD is high. The present study was to compare the postoperative short- and long-term outcomes of PD in between older patients and younger patients.
METHODS
Between 2000 and 2014, patients who underwent PD due to periampullary cancers were enrolled. Patients aged 75 years or over were included in the older group.
RESULTS
Total 1,249 patients were enrolled in this study and 168 patients (13.5%) were included in the older group. Postoperative complication rates, duration of postoperative hospital stay, and 30-day mortality were comparable between the 2 groups, although the admission rate of intensive care unit postoperatively was higher in the older adult group (20.8% vs. 10.5%, P < 0.001). In terms of long-term outcomes, 5-year overall survival rate was lower in the older group (23.4% vs. 41.8%, P < 0.001), and 5-year cumulative recurrence rate was higher in the older group without statistical significance (63.9% vs. 57.9%, P = 0.095). However, there were no statistical differences of cumulative recurrence in pancreatic cancer patients (81.5% vs. 82.5%, P = 0.805).
CONCLUSION
PD for periampullary cancer is a safe and feasible treatment in the older patients. The treatment modality for obtaining better survival outcomes will be investigated.

Keyword

Geriatric assessment; Outcome assessment; Pancreaticoduodenectomy; Recurrence; Survival
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