Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan;98(1):7-14.
doi: 10.4174/astr.2020.98.1.7. Epub 2019 Dec 30.

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

Jae Seung Kang  1 , Hongbeom Kim  1 , Jae Ri Kim  1 , Youngmin Han  1 , Eunjung Kim  1 , Yoonhyeong Byun  1 , Yoo Jin Choi  1 , Wooil Kwon  1 , Jin-Young Jang  1 , Sun-Whe Kim  2
Affiliations

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

Jae Seung Kang et al. Ann Surg Treat Res. 2020 Jan.

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.

Keywords: Geriatric assessment; Outcome assessment; Pancreaticoduodenectomy; Recurrence; Survival.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. (A) Proportion of the elderly patients in pancraticoduodenectomy for periampullary cancer. (B) The rates of R0 resection status and receiving chemotherapy in the elderly group.
Fig. 2
Fig. 2. Comparisons of survival outcomes between the older and control groups who obtained R0 resection status. (A) The 5-year overall survival rate, (B) 5-year cumulative recurrence rate. 5YSR, 5-year overall survival rate; 5YCRR, 5-year cumulative recurrence rate.
Fig. 3
Fig. 3. Comparisons of cumulative recurrence rates in R0 resection patients, pancreatic adenocarcinoma (A), distal common bile duct (CBD) cancer (B), ampullary cancer (C). 5YCRR, 5-year cumulative recurrence rate.
See this image and copyright information in PMC

References

    1. Eshuis WJ, van Eijck CH, Gerhards MF, Coene PP, de Hingh IH, Karsten TM, et al. Antecolic versus retrocolic route of the gastroenteric anastomosis after pancreatoduodenectomy: a randomized controlled trial. Ann Surg. 2014;259:45–51. - PubMed
    1. Casadei R, Zanini N, Morselli-Labate AM, Calculli L, Pezzilli R, Poti O, et al. Prognostic factors in periampullary and pancreatic tumor resection in elderly patients. World J Surg. 2006;30:1992–2001. - PubMed
    1. Kang CM, Kim JY, Choi GH, Kim KS, Choi JS, Lee WJ, et al. Pancreaticoduodenectomy of pancreatic ductal adenocarcinoma in the elderly. Yonsei Med J. 2007;48:488–494. - PMC - PubMed
    1. Katai H, Sasako M, Sano T, Maruyama K. The outcome of surgical treatment for gastric carcinoma in the elderly. Jpn J Clin Oncol. 1998;28:112–115. - PubMed
    1. Kim DY, Joo JK, Ryu SY, Park YK, Kim YJ, Kim SK. Clinicopathologic characteristics of gastric carcinoma in elderly patients: a comparison with young patients. World J Gastroenterol. 2005;11:22–26. - PMC - PubMed