Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China.
From the Department of Pancreatic Surgery, West China Hospital, Sichuan University.
Pancreas. 2020 Sep;49(8):1063-1068. doi: 10.1097/MPA.0000000000001620.
The aim of the study was to evaluate the effect of age on outcomes with pancreatic ductal adenocarcinoma (PDAC) undergoing laparoscopic pancreaticoduodenectomy (LPD).
We retrospectively collected clinical data of consecutive patients with PDAC undergoing LPD from January 2012 to April 2019. The patients were divided into 2 groups according to age at admission for LPD: younger than 70 and 70 years or older.
A total of 147 patients were included (<70 years, n = 96; ≥70 years, n = 51). The elderly LPD patients had lower serum albumin levels (mean, 37.9 [standard deviation, 4.8] g/L vs 40.7 [standard deviation, 6.8] g/L, P = 0.004) and a larger frequency of comorbidities (62.7% vs 36.5%, P = 0.002) than younger patients. The short-term outcomes showed no significant differences. The median overall survival time of the younger patients was not significantly greater than that of the elderly patients (20.0 [95% confidence interval, 16.1-23.9] months vs 19.0 [95% confidence interval, 13.8-24.2] months, P = 0.902).
The short- and long-term outcomes of elderly patients with PDAC after LPD were similar to those of younger patients, despite a higher prevalence of multiple chronic illnesses and poorer nutritional conditioning among the elderly patients. These results show that LPD can be applied safely to elderly patients.
本研究旨在评估年龄对接受腹腔镜胰十二指肠切除术(LPD)的胰腺导管腺癌(PDAC)患者结局的影响。
我们回顾性收集了 2012 年 1 月至 2019 年 4 月期间连续接受 LPD 的 PDAC 患者的临床数据。根据 LPD 时的年龄将患者分为 2 组:年龄小于 70 岁和年龄等于或大于 70 岁。
共纳入 147 例患者(年龄小于 70 岁,n = 96;年龄等于或大于 70 岁,n = 51)。老年 LPD 患者的血清白蛋白水平较低(平均值,37.9 [标准差,4.8] g/L 比 40.7 [标准差,6.8] g/L,P = 0.004),合并症的发生率较高(62.7%比 36.5%,P = 0.002)。短期结局无显著差异。年轻患者的中位总生存时间无显著长于老年患者(20.0 [95%置信区间,16.1-23.9] 个月比 19.0 [95%置信区间,13.8-24.2] 个月,P = 0.902)。
尽管老年患者合并多种慢性疾病和营养状况较差,但 LPD 后老年 PDAC 患者的短期和长期结局与年轻患者相似。这些结果表明 LPD 可安全应用于老年患者。