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

Annals of Surgical Treatment and Research 2020년 98권 1호 p.7 ~ 14
강재승 ( Kang Jae-Seung ) - Seoul National University College of Medicine Department of Surgery

김홍범 ( Kim Hong-Beom ) - Seoul National University College of Medicine Department of Surgery
 ( Kim Jae-Ri ) - Seoul National University College of Medicine Department of Surgery
한영민 ( Han Young-Min ) - Seoul National University College of Medicine Department of Surgery
김은정 ( Kim Eun-Jung ) - Seoul National University College of Medicine Department of Surgery
 ( Byun Yoon-Hyeong ) - Seoul National University College of Medicine Department of Surgery
최유진 ( Choi Yoo-Jin ) - Seoul National University College of Medicine Department of Surgery
권우일 ( Kwon Woo-Il ) - Seoul National University College of Medicine Department of Surgery
장진영 ( Jang Jin-Young ) - Seoul National University College of Medicine Department of Surgery
김선회 ( Kim Sun-Whe ) - National Cancer Center Center for Liver and Pancreatobiliary Cancer

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.

키워드

Geriatric assessment; Outcome assessment; Pancreaticoduodenectomy; Recurrence; Survival
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