Pancreaticoduodenectomy for pancreatic cancer in elderly patients – a single-centre experience

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61383082%3A_____%2F18%3A00000447" target="_blank" >RIV/61383082:_____/18:00000447 - isvavai.cz</a>

Výsledek na webu

<a href="https://www.medvik.cz/bmc/view.do?gid=1277747" target="_blank" >https://www.medvik.cz/bmc/view.do?gid=1277747</a>

DOI - Digital Object Identifier

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Jazyk výsledku

angličtina

Název v původním jazyce

Pancreaticoduodenectomy for pancreatic cancer in elderly patients – a single-centre experience

Popis výsledku v původním jazyce

Conflicting results can be found in the literature with regards to the impact of age on mortality and morbidity associated with pancreaticoduodenectomy. Insufficient methodological quality is a problem in most undertaken studies. Although rather few papers have focused on whether age has any impact on long-term survival after pancreaticoduodenectomy, their conclusions agree – i.e. higher age is not associated with shorter survival after pancreaticoduodenectomy. The aim of this paper is to compare short- and long-term outcomes of pancreaticoduodenectomy for pancreatic cancer in individual age groups. Method: Retrospective comparative analysis of data obtained from medical records of patients after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma at a single centre, in the period 01/2011−12/2015. Differences in morbidity, serious complications (equal to or higher than grade III according to the Clavien-Dindo classification), the incidence of postoperative pancreatic fistula and the probability of completing adjuvant chemotherapy were tested using the chi-square test and Fisher’s exact test, as appropriate, in patient age categories <65 years, 65–75 years and ≥75 years. Long-term survival rates in the individual age categories were evaluated using Kaplan-Meier curves and the long-rank test. The significance level was defined as α = 0.05. Results: The 30-day mortality in patient age categories <65, 65−75 and ≥75 years was 2.22%, 2.78% and 7.69%, respectively (p = 0.60), and the 90-day mortality was 6.66%, 5.56% and 7.69%, respectively (p=0.94). Complication rates grade III and higher according to the Clavien-Dindo classification system were 33.3%, 27.8% and 23.1%, respectively (p=0.73). The estimated median survival was 19.2, 21.1 and 11.8 months (p = 0.26). Complete adjuvant chemotherapy was administered to 84.4%; 55.6% and 15.4% of the patients − depending on the age group (p<0.001). Conclusion: Both short- and long-term outcomes after pancreaticoduodenectomy in selected patients with resectable pancreatic cancer older than 75 years are not significantly different from those achieved in the younger age groups. Thus, the age per se should not represent a contraindication for pancreaticoduodenectomy or adjuvant chemotherapy in patients with pancreatic cancer.

Název v anglickém jazyce

Pancreaticoduodenectomy for pancreatic cancer in elderly patients – a single-centre experience

Popis výsledku anglicky

Conflicting results can be found in the literature with regards to the impact of age on mortality and morbidity associated with pancreaticoduodenectomy. Insufficient methodological quality is a problem in most undertaken studies. Although rather few papers have focused on whether age has any impact on long-term survival after pancreaticoduodenectomy, their conclusions agree – i.e. higher age is not associated with shorter survival after pancreaticoduodenectomy. The aim of this paper is to compare short- and long-term outcomes of pancreaticoduodenectomy for pancreatic cancer in individual age groups. Method: Retrospective comparative analysis of data obtained from medical records of patients after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma at a single centre, in the period 01/2011−12/2015. Differences in morbidity, serious complications (equal to or higher than grade III according to the Clavien-Dindo classification), the incidence of postoperative pancreatic fistula and the probability of completing adjuvant chemotherapy were tested using the chi-square test and Fisher’s exact test, as appropriate, in patient age categories <65 years, 65–75 years and ≥75 years. Long-term survival rates in the individual age categories were evaluated using Kaplan-Meier curves and the long-rank test. The significance level was defined as α = 0.05. Results: The 30-day mortality in patient age categories <65, 65−75 and ≥75 years was 2.22%, 2.78% and 7.69%, respectively (p = 0.60), and the 90-day mortality was 6.66%, 5.56% and 7.69%, respectively (p=0.94). Complication rates grade III and higher according to the Clavien-Dindo classification system were 33.3%, 27.8% and 23.1%, respectively (p=0.73). The estimated median survival was 19.2, 21.1 and 11.8 months (p = 0.26). Complete adjuvant chemotherapy was administered to 84.4%; 55.6% and 15.4% of the patients − depending on the age group (p<0.001). Conclusion: Both short- and long-term outcomes after pancreaticoduodenectomy in selected patients with resectable pancreatic cancer older than 75 years are not significantly different from those achieved in the younger age groups. Thus, the age per se should not represent a contraindication for pancreaticoduodenectomy or adjuvant chemotherapy in patients with pancreatic cancer.

Druh

J_ost - Ostatní články v recenzovaných periodicích

CEP obor

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OECD FORD obor

30212 - Surgery

Projekt

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Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Rozhledy v chirurgii

ISSN

0035-9351

e-ISSN

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Svazek periodika

97

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

5

Strana od-do

34-38

Kód UT WoS článku

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EID výsledku v databázi Scopus

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