Radical Resection of Periampullary Tumors in the Elderly: Evaluation of Long‐term Results

Bathe, Oliver F.; Levi, David; Caldera, Humberto; Franceschi, Dido; Raez, Luis E.; Patel, A; Raub, William; Benedetto, Pasquale; Reddy, Rajender; Hutson, Duane G.; Sleeman, Danny; Livingstone, Alan S.; Levi, Joé U.

doi:10.1007/s002689910056

Cited by 69 publications

(79 citation statements)

References 20 publications

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“…The reported median overall survival ranged from 14-38 months and 5-year survival rates ranged from 12-31% (15,17,27,39). In the present study, the median survival time of the two groups were 17 months in the old group and 23 months in the young group.…”

Section: Discussionmentioning

confidence: 40%

Age does not affect complications and overall survival rate after pancreaticoduodenectomy: Single-center experience and systematic review of literature

Miyazaki

Kobayashi

Amikura

et al. 2016

BST

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Section: Discussionmentioning

confidence: 40%

Age does not affect complications and overall survival rate after pancreaticoduodenectomy: Single-center experience and systematic review of literature

Miyazaki

Kobayashi

Amikura

et al. 2016

BST

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“…Although the elderly population has a higher prevalence of comorbidities, American Society of Anesthisiologists (ASA) scores and co-morbidities were evenly distributed between the two age groups [36,39,40,42,43]. Furthermore, patients with ASA grade IV were either excluded from pancreatic resection or were in the minority [24, 32-34, 38, 39].…”

Section: Pancreatic Resection For Pancreatic and Ampullary Cancermentioning

confidence: 99%

Should We Deny Surgery for Malignant Hepato‐Pancreatico‐Biliary Tumors to Elderly Patients?

Petrowsky

Clavien

2005

World j. surg.

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Abstract. Malignant hepato-pancreatico-biliary (HPB) tumors have their highest incidence within the sixth to eighth decades of life. The aging of the world population has resulted in a dramatic increase in the number of elderly patients considered for resection of malignant HPB tumors. Because elderly patients are more likely to have more co-morbidities, cognitive impairment, and decreased life expectancy, the benefit and appropriateness of these procedures must be scrutinized for geriatric patients. Therefore, many surgeons have compared the perioperative and long-term outcome of hepatic and pancreatic resections for elderly and younger patients. In most series the elderly population was defined by an age of 70 years or older. The results demonstrate that hepatic resection for hepatocellular carcinoma and colorectal liver metastases can be safely performed in well-selected elderly patients with long-term outcome comparable to younger patients. Similar findings are also reported for pancreatic resection in elderly patients with either ampullary or pancreatic cancer. Although the survival benefit of pancreatico-duodenectomy is limited in all age groups, the absence of competitive therapy justifies this procedure as the sole curative option in younger as well as older patients. Data on resection of gallbladder cancer and hilar bile duct cancer in the elderly are sparse, but there is evidence from large series on resection of these types of tumors that advanced age per se is not a risk factor for reduced outcome. Therefore, surgical options should not be denied to elderly patients with a malignant HPB tumor, and the evaluation should include surgeons expert in HPB surgery.

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“…Some studies have shown that for resectable pancreatic carcinoma, pancreatic resections can be performed for the elderly with acceptable morbidity and mortality rates and possible long-term outcome [17,18,19,20,21,22,23,24,25]. However, in locally advanced pancreatic carcinoma treated with chemoradiotherapy, the tolerability, efficacy of treatment and long-term outcome have not been discussed extensively.…”

Section: Introductionmentioning

confidence: 99%

Chemoradiotherapy for Locally Advanced Pancreatic Carcinoma in Elderly Patients

Morizane¹,

Okusaka²,

Ito

et al. 2005

Oncology

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Objectives: Chemoradiotherapy, which is one of the standard treatments for locally advanced pancreatic carcinoma, is considered a high-risk procedure in elderly patients. This study investigated the outcome and tolerability of this treatment in elderly patients. Methods: We reviewed our database from November 1993 to March 2003 and retrospectively examined the clinical data of patients with histologically confirmed exocrine pancreatic carcinomas that were nonresectable but confined to the pancreatic region, who were treated with protracted 5-fluorouracil infusion (200 mg/m²/day) and concurrent radiotherapy (50.4 Gy in 28 fractions over 5.5 weeks). We evaluated the outcome of patients ≧70 years and those <70 years. Results: There were 19 patients ≧70 and 39 patients <70. On pretreatment evaluation, the elderly patients showed lower serum albumin levels, lower transaminase levels, better ECOG performance status, more frequent body weight loss and less frequent abdominal and/or back pain with the administration of morphine than the younger patients. There were no significant differences in the frequency of severe toxicity. Neither the response rate nor the incidence of treatment discontinuation differed significantly between the two groups. The median survival time was longer in the elderly patients than in the younger patients (11.3 vs. 9.5 months, p = 0.04). Conclusions: With careful patient selection, chemoradiotherapy can be one of the treatment options for locally advanced pancreatic carcinoma in elderly patients.

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Radical Resection of Periampullary Tumors in the Elderly: Evaluation of Long‐term Results

Cited by 69 publications

References 20 publications

Age does not affect complications and overall survival rate after pancreaticoduodenectomy: Single-center experience and systematic review of literature

Age does not affect complications and overall survival rate after pancreaticoduodenectomy: Single-center experience and systematic review of literature

Should We Deny Surgery for Malignant Hepato‐Pancreatico‐Biliary Tumors to Elderly Patients?

Chemoradiotherapy for Locally Advanced Pancreatic Carcinoma in Elderly Patients

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