TY - JOUR
T1 - The safety of a pancreaticoduodenectomy in patients older than 80 years
T2 - Risk vs. benefits
AU - Melis, Marcovalerio
AU - Marcon, Francesca
AU - Masi, Antonio
AU - Pinna, Antonio
AU - Sarpel, Umut
AU - Miller, George
AU - Moore, Harvey
AU - Cohen, Steven
AU - Berman, Russell
AU - Pachter, H. Leon
AU - Newman, Elliot
PY - 2012/9
Y1 - 2012/9
N2 - 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.
AB - 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.
KW - age
KW - octogenarians
KW - overall survival
KW - pancreatic cancer
KW - pancreticoduodenctomy
KW - post-operative morbidity
UR - http://www.scopus.com/inward/record.url?scp=84865144969&partnerID=8YFLogxK
U2 - 10.1111/j.1477-2574.2012.00484.x
DO - 10.1111/j.1477-2574.2012.00484.x
M3 - Article
C2 - 22882194
AN - SCOPUS:84865144969
SN - 1365-182X
VL - 14
SP - 583
EP - 588
JO - HPB
JF - HPB
IS - 9
ER -