Elderly patients have similar short term outcomes and five-year survival compared to younger patients after pancreaticoduodenectomy
| Autor: | Mohammad Abu Hilal, Awad Shamali, Mahmoud Abuawad, Zaed Hamaday, Salvatore Barbaro, Bashar Jaber, Henry D. De’Ath |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis medicine.medical_treatment Adenocarcinoma Group B Pancreaticoduodenectomy 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Internal medicine medicine Humans Vascular resection Pancreas Lymph node Aged Aged 80 and over business.industry Age Factors Cancer General Medicine Middle Aged medicine.disease United Kingdom Surgery Pulmonary embolism Pancreatic Neoplasms medicine.anatomical_structure 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology business |
| Zdroj: | International Journal of Surgery. 45:138-143 |
| ISSN: | 1743-9191 |
| Popis: | Background Outcomes following pancreaticoduodenectomy (PD) in elderly patients in the United Kingdom (UK) remain uncertain. This study aimed to analyse peri-operative outcomes in the elderly, and investigate the impact of age on five-year survival following PD in a UK tertiary centre. Materials and methods All patients who underwent PD in a single Hepatobiliary and Pancreatic unit in the UK between January 2007 to December 2015 were analysed from a prospectively collected database. Individuals were divided into two groups (Group A Results Five hundred and twenty-four patients were included (Group A n = 422, Group B n = 102). Post-operative cardiac events and peri-operative mortality were higher in the elderly (10.8 vs 3.6%, p = 0.008 and 5.9 vs 1.9%, 0.037, respectively). Multivariate analysis revealed only ASA score (OR 0.279, 95% CI 0.063–1.130), post-pancreatectomy haemorrhage (OR 0.055, 95% CI 0.006–0.518) and pulmonary embolism (OR 0.03, 95% CI 0.00–0.148) as independent risk factors for peri-operative mortality. Age was not (OR 0.978, 95% CI 0.911–1.049). Median survival was 22 months in Group A and 19 months in Group B (p = 0.165). Predictors of five-year survival included vascular resection (OR 0.171, 95% CI 0.053–0.549), positive margin (OR 0.256, 95% CI 0.102–0.641), lympho-vascular invasion (OR 0.392, 95% CI 0.160–0.958) and lymph node ratio (OR 67.381, 95% CI 3.301–1375.586), but not age (OR 1.012, 95% CI 0.972–1.054). Conclusion Older patients have similar peri-operative outcomes and five-year survival compared to younger counterparts after PD in a UK tertiary centre, and should be considered for surgical resection of pancreatic and periampullary cancers. |
| Databáze: | OpenAIRE |
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