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Comparative Study
. 2012 Sep;14(9):583-8.
doi: 10.1111/j.1477-2574.2012.00484.x. Epub 2012 May 29.

The safety of a pancreaticoduodenectomy in patients older than 80 years: risk vs. benefits

Marcovalerio Melis  1 , Francesca Marcon, Antonio Masi, Antonio Pinna, Umut Sarpel, George Miller, Harvey Moore, Steven Cohen, Russell Berman, H Leon Pachter, Elliot Newman
Affiliations
Comparative Study

The safety of a pancreaticoduodenectomy in patients older than 80 years: risk vs. benefits

Marcovalerio Melis et al. HPB (Oxford). 2012 Sep.

Abstract

Background: A pancreaticoduodenectomy (PD) offers the only chance of a cure for pancreatic cancer and can be performed with low mortality and morbidity. However, little is known about outcomes of a PD in octogenarians.

Methods: Differences in two groups of patients (Group Y, <80 and Group O, ≥80 year-old) who underwent a PD for pancreatic adenocarcinoma were analysed. Study end-points were length of post-operative stay, overall morbidity, 30-day mortality and overall survival.

Results: There were 175 patients in Group Y (mean age 64 years) and 25 patients in Group O (mean age 83 years). Octogenarians had worse Eastern Cooperative Oncology Group (ECOG) Performance Status (PS ≥1: 90% vs. 51%) and American Society of Anesthesiology (ASA) score (>2: 71% vs. 47%). The two groups were similar in underlying co-morbidities, operative time, rates of portal vein resection, intra-operative complications, blood loss, pathological stage and status of resection margins. Octogenarians had a longer post-operative stay (20 vs. 14 days) and higher overall morbidity (68% vs. 44%). There was a single death in each group. At a median follow-up of 13 months median survival appeared similar in the two groups (17 vs. 13 months).

Conclusions: As 30-day mortality and survival are similar to those observed in younger patients, a PD can be offered to carefully selected octogenarians.

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Figures

Figure 1
Figure 1
Overall survival after a pancreaticoduodenectomy (PD) for pancreatic adenocarcinoma in octogenarians compared with younger patients
See this image and copyright information in PMC

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