Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians

Backgrounds: Pancreaticoduodenectomy (PD) remains the only hope of a cure in selected patients with pancreatic adenocarcinoma (PAC). With an aging population, there will be an increasing number of very elderly patients being diagnosed with PAC of whom a selected proportion would be suitable for PD....

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Main Authors: Yeqian Huang, Ramesh Damodaran Prabha, Terence C. Chua, Jennifer Arena, Krishna Kotecha, Anubhav Mittal, Anthony J. Gill, Jaswinder S. Samra
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-02-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2021.617286/full
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spelling doaj-58c9584344594528b3a00df941f897112021-02-02T08:22:11ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2021-02-01810.3389/fsurg.2021.617286617286Safety and Efficacy of Pancreaticoduodenectomy in OctogenariansYeqian Huang0Yeqian Huang1Yeqian Huang2Ramesh Damodaran Prabha3Terence C. Chua4Terence C. Chua5Terence C. Chua6Jennifer Arena7Krishna Kotecha8Anubhav Mittal9Anthony J. Gill10Anthony J. Gill11Anthony J. Gill12Jaswinder S. Samra13Jaswinder S. Samra14Department of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, AustraliaNorthern Clinical School, University of Sydney, Sydney, NSW, AustraliaSouth Western Clinical School, University of New South Wales, Sydney, NSW, AustraliaDepartment of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, AustraliaDepartment of Surgery, QE II Jubilee Hospital, Metro South Health, Brisbane, QLD, AustraliaSchool of Medicine, Griffith University, Gold Coast, QLD, AustraliaDiscipline of Surgery, The University of Queensland, Brisbane, QLD, AustraliaDepartment of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, AustraliaDepartment of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, AustraliaDepartment of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, AustraliaNorthern Clinical School, University of Sydney, Sydney, NSW, AustraliaCancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, St Leonards, NSW, AustraliaDeparment of Anatomical Pathology, Royal North Shore Hospital, St Leonards, NSW, AustraliaDepartment of Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, NSW, AustraliaMacquarie University Hospital, Macquarie University, Sydney, NSW, AustraliaBackgrounds: Pancreaticoduodenectomy (PD) remains the only hope of a cure in selected patients with pancreatic adenocarcinoma (PAC). With an aging population, there will be an increasing number of very elderly patients being diagnosed with PAC of whom a selected proportion would be suitable for PD. However, the literature on outcomes of elderly patients after PD remains ambiguous. Therefore, the aim of this study was to examine the safety and efficacy of PD in octogenarians with PAC.Methods: A retrospective analysis of 304 patients with PAC undergoing PD. Patients were divided into two age groups using age of 80 years old as the cut-off.Results: Overall mortality and major morbidity rates were 0.5 and 18.5%, respectively. The octogenarian group had a higher rate of mortality (6.3%, n = 1, p < 0.001), a higher rate of major morbidity (37.5%, n = 6, p = 0.042) and a longer hospital stay (p = 0.035). However, median survival of octogenarians was 15.6 months. Multivariate analysis showed age was not identified as a prognostic factor for major morbidity and overall survival.Conclusion: Age alone should not be an exclusion criterion for consideration of PD. With careful selection, PD can be safely performed in octogenarians. Elderly patients should be referred to a specialized unit for an objective assessment to determine the suitability for this aggressive but potential curative approach.https://www.frontiersin.org/articles/10.3389/fsurg.2021.617286/fullwhipplepancreaticodoudenectomyoctogenarianolderelderlypancreatic adenocarcinoma
collection DOAJ
language English
format Article
sources DOAJ
author Yeqian Huang
Yeqian Huang
Yeqian Huang
Ramesh Damodaran Prabha
Terence C. Chua
Terence C. Chua
Terence C. Chua
Jennifer Arena
Krishna Kotecha
Anubhav Mittal
Anthony J. Gill
Anthony J. Gill
Anthony J. Gill
Jaswinder S. Samra
Jaswinder S. Samra
spellingShingle Yeqian Huang
Yeqian Huang
Yeqian Huang
Ramesh Damodaran Prabha
Terence C. Chua
Terence C. Chua
Terence C. Chua
Jennifer Arena
Krishna Kotecha
Anubhav Mittal
Anthony J. Gill
Anthony J. Gill
Anthony J. Gill
Jaswinder S. Samra
Jaswinder S. Samra
Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians
Frontiers in Surgery
whipple
pancreaticodoudenectomy
octogenarian
older
elderly
pancreatic adenocarcinoma
author_facet Yeqian Huang
Yeqian Huang
Yeqian Huang
Ramesh Damodaran Prabha
Terence C. Chua
Terence C. Chua
Terence C. Chua
Jennifer Arena
Krishna Kotecha
Anubhav Mittal
Anthony J. Gill
Anthony J. Gill
Anthony J. Gill
Jaswinder S. Samra
Jaswinder S. Samra
author_sort Yeqian Huang
title Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians
title_short Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians
title_full Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians
title_fullStr Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians
title_full_unstemmed Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians
title_sort safety and efficacy of pancreaticoduodenectomy in octogenarians
publisher Frontiers Media S.A.
series Frontiers in Surgery
issn 2296-875X
publishDate 2021-02-01
description Backgrounds: Pancreaticoduodenectomy (PD) remains the only hope of a cure in selected patients with pancreatic adenocarcinoma (PAC). With an aging population, there will be an increasing number of very elderly patients being diagnosed with PAC of whom a selected proportion would be suitable for PD. However, the literature on outcomes of elderly patients after PD remains ambiguous. Therefore, the aim of this study was to examine the safety and efficacy of PD in octogenarians with PAC.Methods: A retrospective analysis of 304 patients with PAC undergoing PD. Patients were divided into two age groups using age of 80 years old as the cut-off.Results: Overall mortality and major morbidity rates were 0.5 and 18.5%, respectively. The octogenarian group had a higher rate of mortality (6.3%, n = 1, p < 0.001), a higher rate of major morbidity (37.5%, n = 6, p = 0.042) and a longer hospital stay (p = 0.035). However, median survival of octogenarians was 15.6 months. Multivariate analysis showed age was not identified as a prognostic factor for major morbidity and overall survival.Conclusion: Age alone should not be an exclusion criterion for consideration of PD. With careful selection, PD can be safely performed in octogenarians. Elderly patients should be referred to a specialized unit for an objective assessment to determine the suitability for this aggressive but potential curative approach.
topic whipple
pancreaticodoudenectomy
octogenarian
older
elderly
pancreatic adenocarcinoma
url https://www.frontiersin.org/articles/10.3389/fsurg.2021.617286/full
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