老年患者胰十二指肠切除术的有效性研究
Study on the Validity of Pancreaticoduodenectomy in the Elderly.
作者信息
Futagawa Yasuro, Kanehira Masaru, Furukawa Kenei, Kitamura Hiroaki, Yoshida Seiya, Usuba Teruyuki, Misawa Takeyuki, Ishida Yuichi, Okamoto Tomoyoshi, Yanaga Katsuhiko
机构信息
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
出版信息
Anticancer Res. 2017 Sep;37(9):5309-5316. doi: 10.21873/anticanres.11957.
AIM
Pancreaticoduodenectomy (PD) is still the only curative treatment for periampullary cancer. Confirming the outcomes of PD in elderly patients is important as the aging population continues to grow.
PATIENTS AND METHODS
We analyzed 340 patients with periampullary cancer who underwent PD, dividing them into three groups by age: group A: aged 64 years or younger, n=115; group B: 65-74 years, n=144; and group C: 75 years or older, n=81.
RESULTS
Group C had a significantly higher 60-day mortality of 6.3% (p=0.04), the lowest 5-year overall survival rate of 9.9% (p=0.02), and there was no impact of staging of the Union for International Cancer Control classification on overall survival of patients with pancreatic cancer. Independent prognostic factors of group C in the multivariate analysis were pancreatic cancer and reoperation.
CONCLUSION
For elderly patients aged 75 years or over, caution should be exercised in selecting PD for patients with pancreatic cancer.
目的
胰十二指肠切除术（PD）仍是壶腹周围癌的唯一根治性治疗方法。随着老年人口持续增长，确认老年患者接受PD的治疗效果很重要。
患者与方法
我们分析了340例行PD的壶腹周围癌患者，按年龄将他们分为三组：A组：64岁及以下，n = 115；B组：65 - 74岁，n = 144；C组：75岁及以上，n = 81。
结果
C组60天死亡率显著更高，为6.3%（p = 0.04），5年总生存率最低，为9.9%（p = 0.02），国际癌症控制联盟分类分期对胰腺癌患者的总生存率没有影响。多因素分析中C组的独立预后因素为胰腺癌和再次手术。
结论
对于75岁及以上的老年患者，选择胰腺癌患者进行PD时应谨慎。
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