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Comparative Study
. 2017 May 7;23(17):3077-3083.
doi: 10.3748/wjg.v23.i17.3077.

Pancreaticoduodenectomy in patients ≥ 75 years of age: Are there any differences with other age ranges in oncological and surgical outcomes? Results from a tertiary referral center

Salvatore Paiella  1 , Matteo De Pastena  1 , Tommaso Pollini  1 , Giovanni Zancan  1 , Debora Ciprani  1 , Giulia De Marchi  1 , Luca Landoni  1 , Alessandro Esposito  1 , Luca Casetti  1 , Giuseppe Malleo  1 , Giovanni Marchegiani  1 , Massimiliano Tuveri  1 , Enrico Marrano  1 , Laura Maggino  1 , Erica Secchettin  1 , Deborah Bonamini  1 , Claudio Bassi  1 , Roberto Salvia  1
Affiliations
Comparative Study

Pancreaticoduodenectomy in patients ≥ 75 years of age: Are there any differences with other age ranges in oncological and surgical outcomes? Results from a tertiary referral center

Salvatore Paiella et al. World J Gastroenterol. .

Abstract

Aim: To compare surgical and oncological outcomes after pancreaticoduodenectomy (PD) in patients ≥ 75 years of age with two younger cohorts of patients.

Methods: The prospectively maintained Institutional database of pancreatic resection was queried for patients aged ≥ 75 years (late elderly, LE) submitted to PD for any disease from January 2010 to June 2015. We compared clinical, demographic and pathological features and survival outcomes of LE patients with 2 exact matched cohorts of younger patients [≥ 40 to 64 years of age (adults, A) and ≥ 65 to 74 years of age (young elderly, YE)] submitted to PD, according to selected variables.

Results: The final LE population, as well as the control groups, were made of 96 subjects. Up to 71% of patients was operated on for a periampullary malignancy and pancreatic cancer (PDAC) accounted for 79% of them. Intraoperative data (estimated blood loss and duration of surgery) did not differ among the groups. The overall complication rate was 65.6%, 61.5% and 58.3% for LE, YE and A patients, respectively, P = NS). Reoperation and cardiovascular complications were significantly more frequent in LE than in YE and A groups (P = 0.003 and P = 0.019, respectively). When considering either all malignancies and PDAC only, the three groups did not differ in survival. Considering all benign diseases, the estimated mean survival was 58 and 78 mo for ≥ and < 75 years of age (YE + A groups), respectively (P = 0.012).

Conclusion: Age is not a contraindication for PD. A careful selection of LE patients allows to obtain good surgical and oncological results.

Keywords: Elderly; Pancreatic cancer; Pancreatic surgery; Pancreaticoduodenectomy; Periampullary cancer.

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Conflict of interest statement

Conflict-of-interest statement: None of the authors have received fees for serving as a speaker or are consultant/advisory board member for any organizations. None of the authors have received research funding from any organizations. None of the authors are employees of any organizations. None of the authors own stocks and/or share in any organizations. None of the authors own patents.

Figures

Figure 1
Figure 1
Overall survival by Kaplan-Meier method according to the different age groups. See text for further details. A: Adults; YE: Young elderly; LE: Late elderly; PDAC: Pancreatic cancer.
See this image and copyright information in PMC

References

    1. Etzioni DA, Liu JH, Maggard MA, Ko CY. The aging population and its impact on the surgery workforce. Ann Surg. 2003;238:170–177. - PMC - PubMed
    1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90. - PubMed
    1. Sukharamwala P, Thoens J, Szuchmacher M, Smith J, DeVito P. Advanced age is a risk factor for post-operative complications and mortality after a pancreaticoduodenectomy: a meta-analysis and systematic review. HPB (Oxford) 2012;14:649–657. - PMC - PubMed
    1. Hatzaras I, George N, Muscarella P, Melvin WS, Ellison EC, Bloomston M. Predictors of survival in periampullary cancers following pancreaticoduodenectomy. Ann Surg Oncol. 2010;17:991–997. - PMC - PubMed
    1. Khan S, Sclabas G, Lombardo KR, Sarr MG, Nagorney D, Kendrick ML, Donohue JH, Que FG, Farnell MB. Pancreatoduodenectomy for ductal adenocarcinoma in the very elderly; is it safe and justified? J Gastrointest Surg. 2010;14:1826–1831. - PubMed

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