RT Journal Article
SR Electronic
T1 Eligibility Criteria Specific to Pancreaticoduodenectomy for Octogenarians: Single-center Opinion
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 2037
OP 2043
VO 37
IS 4
A1 SHUNICHI SHIOZAWA
A1 TAKEBUMI USUI
A1 KOTARO KUHARA
A1 AKIRA TSUCHIYA
A1 TATSUOMI MIYAUCHI
A1 TEPPEI KONO
A1 YUKIO SHIMOJIMA
A1 SHINICHI ASAKA
A1 KENTARO YAMAGUCHI
A1 HAJIME YOKOMIZO
A1 TAKESHI SHIMAKAWA
A1 KAZUHIKO YOSHIMATSU
A1 TAKAO KATSUBE
A1 YOSHIHIKO NARITAKA
YR 2017
UL http://ar.iiarjournals.org/content/37/4/2037.abstract
AB Background/Aim: Pancreaticoduodenectomy (PD) treatment outcomes in elderly patients have been reported to be acceptable, but the eligibility criteria are not clear. To elucidate the importance of PD in octogenarians in particular, we set five eligibility criteria for elderly patients based on preoperative cardiac and pulmonary function, nutritional status, daily activity status, and psychological independence status for the first time and evaluated prospectively whether the validity of patient selection was adaptable. Patients and Methods: The study population consisted of 222 patients with pancreaticobiliary cancer aged over 70 years. The patients were divided into two groups: 192 patients as septuagenarians and 30 as octogenarians. Postoperative morbidity and long-term outcome were compared between the two groups, and prognostic factors relating to survival time were identified. Results: Octogenarians had a significantly higher frequency of two or more comorbidities (p<0.0001). The difference in the mortality rates between the two groups was not significant, being 3.3% and 4.2%, respectively. No difference between the two groups was found in overall survival rate, including deaths due to other diseases, for any type of pancreaticobiliary cancer. Independent prognostic factors relating to survival duration were intraoperative blood loss (p=0.0004) and duration of surgery (p=0.0093). Conclusion: These five eligibility criteria for PD in elderly patients are also satisfactorily applicable to octogenarian patients. These criteria may be helpful when uncertainties arise regarding the selection of PD.