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KMID : 0371420200980010007
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Annals of Surgical Treatment and Research
2020 Volume.98 No. 1 p.7 ~ p.14
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Short- and long-term outcomes of pancreaticoduodenectomy in elderly patients with periampullary cancer
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Kang Jae-Seung
Kim Hong-Beom
Kim Jae-Ri
Han Young-Min
Kim Eun-Jung
Byun Yoon-Hyeong
Choi Yoo-Jin
Kwon Woo-Il
Jang Jin-Young
Kim Sun-Whe
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Abstract
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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.
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KEYWORD
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Geriatric assessment, Outcome assessment, Pancreaticoduodenectomy, Recurrence, Survival
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