Optimal Treatment for Octogenarians With Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma: A Multicenter Retrospective Study.

Autor:	Satoi S; From the Department of Surgery, Kansai Medical University, Osaka., Yamamoto T; From the Department of Surgery, Kansai Medical University, Osaka., Uchida K; Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi., Fujii T; Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama., Kin T; Center for Gastroenterology, Teine-Keijinkai Hospital., Hirano S; Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo., Hanada K; Department of Gastroenterology, JA Onomichi General Hospital, Hiroshima., Itoi T; Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo., Murakami Y; Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima., Igarashi H; Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka., Eguchi H; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka., Kuroki T; Department of Surgery, National Hospital Nagasaki Medical Center, Nagasaki., Shimizu Y; Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya., Tani M; Department of Surgery, Shiga University of Medical Science, Otsu., Tanno S; Department of Gastroenterology, IMS Sapporo Digestive Center General Hospital, Sapporo., Tsuji Y; Department of Clinical Education, Shiga University of Medical Science, Otsu., Hirooka Y; Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University, Aichi., Masamune A; Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai., Shimokawa T; Clinical Study Support Center., Yamaue H; Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama., Okazaki K; Department of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan.
Jazyk:	angličtina
Zdroj:	Pancreas [Pancreas] 2020 Jul; Vol. 49 (6), pp. 837-844.
DOI:	10.1097/MPA.0000000000001579
Abstrakt:	Objectives: The objective of this study was to clarify the role of pancreatectomy for patients with resectable and borderline resectable pancreatic ductal adenocarcinoma aged 80 years or older using a nationwide audit by the Japan Pancreas Society. Methods: Data were collected from 39 institutions from 2007 to 2014. The primary endpoint was overall survival, and secondary endpoints were surgical outcomes and predictive factors for prognosis. Results: Data were obtained from 556 octogenarians who underwent pancreatectomy (n = 369, 66%), chemo(radio)therapy (n = 99, 18%), and palliative therapy (n = 88, 16%). Median survival times were 20.6, 18.6, and 8.8 months in each group, respectively. Even after propensity score matching, median survival time in the surgery group (22.8 months) was significantly higher than that in the chemotherapy group (18.5 months; hazard ratio, 0.64 [95% confidence interval, 0.44-0.93]; P = 0.020). Significant independent prognostic factors were body mass index, lymph node metastasis, and tumor diameter in the surgery group, and serum albumin level, American Society of Anesthesiologists classification, body mass index, modified Glasgow prognostic score, second-line chemotherapy, and tumor diameter in the chemotherapy group. Conclusions: Octogenarians with resectable/borderline resectable pancreatic ductal adenocarcinoma can be recommended for pancreatectomy according to mental and physical fitness for surgical procedures.
Databáze:	MEDLINE
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