Kang Jae Seung, Kim Hongbeom, Kim Jae Ri, Han Youngmin, Kim Eunjung, Byun Yoonhyeong, Choi Yoo Jin, Kwon Wooil, Jang Jin-Young, Kim Sun-Whe
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Korea.
Ann Surg Treat Res. 2020 Jan;98(1):7-14. doi: 10.4174/astr.2020.98.1.7. Epub 2019 Dec 30.
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.
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.
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% . 10.5%, P < 0.001). In terms of long-term outcomes, 5-year overall survival rate was lower in the older group (23.4% . 41.8%, P < 0.001), and 5-year cumulative recurrence rate was higher in the older group without statistical significance (63.9% . 57.9%, P = 0.095). However, there were no statistical differences of cumulative recurrence in pancreatic cancer patients (81.5% . 82.5%, P = 0.805).
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.
近期老年癌症患者也接受了胰十二指肠切除术（PD）。PD的并发症发生率较高。本研究旨在比较老年患者和年轻患者PD术后的短期和长期结局。
纳入2000年至2014年间因壶腹周围癌接受PD的患者。年龄75岁及以上的患者纳入老年组。
本研究共纳入1249例患者，其中168例（13.5%）纳入老年组。两组术后并发症发生率、术后住院时间和30天死亡率相当，尽管老年成人组术后重症监护病房入住率较高（20.8%对10.5%，P<0.001）。在长期结局方面，老年组5年总生存率较低（23.4%对41.8%，P<0.001），老年组5年累积复发率较高，但无统计学意义（63.9%对57.9%，P=0.095）。然而，胰腺癌患者的累积复发率无统计学差异（81.5%对82.5%，P=0.805）。
壶腹周围癌的PD对老年患者是一种安全可行的治疗方法。将研究获得更好生存结局的治疗方式。
