Outcome of pancreatic resection in elderly patients
© Sperti et al; licensee BioMed Central Ltd. 2009
Published: 1 April 2009
The increasing aging of the Western population is obviously accomplished by an increasing number of older patients with cancer, including pancreatic cancer. Since surgical resection remains the treatment of choice for pancreatic and periampullary neoplasms, increasing number of elderly patients are being referred for pancreatic resection. Recently, some surgical experiences reported an acceptable morbidity rate and outcome in patients with advanced age. This retrospective study analyzes the effects of age on short-term and long-term outcome in a large series of patients who underwent resection for pancreatic or periampullary disease.
Materials and methods
Data were collected on 317 consecutive patients who underwent pancreatic resection between 2000 and 2007, divided into two groups: group 1, patients under 75 years of age, and group 2, patients with 75 years of age or older. Patients underwent standardized preoperative assessment of general medical conditions, blood tests, tumor marker CA 19-9 determination, abdominal CT scan, and when needed, MRI or PET. Surgical technique included pylorus-preserving pancreaticoduodenectomy for tumors of the head of the pancreas and distal pancreatectomy for tumors located in the body or tail. Total pancreatectomy was reserved for microscopic invasion of the line of resection. For selected cases of benign or border-line tumors a limited resection was performed. The morbidity and mortality rate included all complications or death after surgery until discharge from hospital. In patients with pancreatic cancer, age, stage, lymph node status, grading and radicality of resection were recorded as potentially prognostic factors. Statistical analysis was performed using the SPSS for Windows rel. 15.0. Patient overall survival and disease-free survival (DFS) were evaluated using the Kaplan-Meier method and compared with the Log-Rank test. Independent prognostic variables were examined with Cox regression analysis. Statistical significance was considered as p < 0.05.
<75 yrs (n = 265)
>75 yrs (n = 52)
Duodenum-preserving head resection
This article is published under license to BioMed Central Ltd.