Surgical resection for intraductal papillary mucinous neoplasm in the older population.

Autor: Poruk KE; Department of Surgery, The Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA. Electronic address: porukk@mskcc.org., Shahrokni A; Department of Geriatrics, The Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA. Electronic address: shahroka@mskcc.org., Brennan MF; Department of Surgery, The Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2022 Jun; Vol. 48 (6), pp. 1293-1299. Date of Electronic Publication: 2021 Dec 03.
DOI: 10.1016/j.ejso.2021.12.001
Abstrakt: Background: Surgery for intraductal papillary mucinous neoplasm (IPMN) in older adults requires a careful balance of risk and benefit. We sought to analyze patient outcomes in the older individuals after pancreatic resection for IPMN.
Methods: Retrospective analysis of a prospectively maintained database was performed for patients 65 years or older undergoing IPMN resection between January 1, 2012 and December 31, 2017. Statistical analysis was performed based on age and Memorial Sloan Kettering Frailty Index (MSKFI) score.
Results: 148 patients underwent resection of an IPMN, including five patients who required two operations for recurrent disease. Median age at surgery was 74 (range, 65-90 years), and 52% were male. Most patients underwent pancreaticoduodenectomy (53%) or distal pancreatectomy/splenectomy (35%). An associated adenocarcinoma was seen on pathology for 56 patients (37%). Median hospital length of stay was 7 days (range, 4-46 days). Grade 3 or higher post-operative complications on the Clavien-Dindo classification scale were seen in 20%. No patient died within 30-days. Patient outcomes were evaluated by age, split at age ≥75 (considered "elderly"), and separately by MSKFI score. No differences in post-operative morbidity or mortality was seen when stratified by age (65 - 74 vs > 75 years) or by MSKFI frailty score.
Conclusion: Pancreatic resection can be safely performed in selected patients 65 years and older with low morbidity and mortality. More analysis is needed to determine if MSKFI score is a useful predictor of complications in older individuals.
Competing Interests: Declaration of competing interest The project was supported, in part, by the Beatriz and Samuel Seaver Foundation, the MSK Cancer and Aging Program, and NIH/NCI Cancer Center Support Grant P30 CA008748. Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the funding organizations. The authors of this manuscript otherwise have no conflicts of interest to declare for this project.
(Copyright © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
Databáze: MEDLINE
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