老年患者的胰腺癌切除术

Pancreatic cancer resection in elderly patients.

作者信息

DiCarlo V, Balzano G, Zerbi A, Villa E

机构信息

Department of Surgery, San Raffaele Hospital, Milan, Italy.

出版信息

Br J Surg. 1998 May;85(5):607-10. doi: 10.1046/j.1365-2168.1998.00685.x.

DOI:10.1046/j.1365-2168.1998.00685.x

PMID:9635804

Abstract

BACKGROUND

Pancreatic cancer resection is considered a high-risk procedure in patients aged 70 years or older.

METHODS

Some 398 patients with pancreatic adenocarcinoma, observed between 1990 and 1995, were reviewed. Operative outcome and survival of 33 patients aged 70 years or more were compared with findings in 85 younger patients who underwent resection.

RESULTS

Resectability was not significantly different between the elderly and younger patients; neither were mortality or overall morbidity. However, patients aged 70 years or more had more relaparotomies (P < 0.01) and more haemorrhagic complications (P < 0.001). Nutritional recovery after resection was satisfying even for elderly patients (body-weight gain and increase in serum albumin concentrations, P < 0.05). Univariate analysis showed a moderately poorer survival in the elderly (P = 0.09). Multivariate analysis demonstrated that tumour diameter, grading and Union Internacional Contra la Cancrum stage were independent prognostic factors, whereas age was not.

CONCLUSION

Patients aged 70 years or more can benefit from pancreatic cancer resection similarly to younger patients.

摘要

背景

在70岁及以上的患者中，胰腺癌切除术被认为是一项高风险手术。

方法

回顾了1990年至1995年间观察到的约398例胰腺腺癌患者。将33例70岁及以上患者的手术结果和生存率与85例接受切除术的年轻患者的结果进行了比较。

结果

老年患者和年轻患者之间的可切除性没有显著差异；死亡率或总体发病率也没有显著差异。然而，70岁及以上的患者再次剖腹手术更多（P < 0.01），出血并发症更多（P < 0.001）。即使是老年患者，切除术后的营养恢复也令人满意（体重增加和血清白蛋白浓度升高，P < 0.05）。单因素分析显示老年患者的生存率略低（P = 0.09）。多因素分析表明，肿瘤直径、分级和国际抗癌联盟分期是独立的预后因素，而年龄不是。