ヒグチ リヨウタ   Higuchi Riyouta
  樋口 亮太
   所属   医学部 医学科(附属八千代医療センター)
   職種   講師
論文種別 原著
言語種別 英語
査読の有無 査読なし
表題 Evaluation of the validity of pancreatectomy for very elderly patients with pancreatic ductal adenocarcinoma.
掲載誌名 正式名:Langenbeck's archives of surgery
略  称:Langenbecks Arch Surg
ISSNコード:14352451/14352443
掲載区分国外
巻・号・頁 406(4),pp.1081-1092
著者・共著者 IZUMO Wataru†, HIGUCHI Ryota, FURUKAWA Toru, YAZAWA Takehisa, MATSUNAGA Yutaro, SHIIHARA Masahiro, YAMAMOTO Masakazu
担当区分 2nd著者
発行年月 2021/06
概要 PURPOSE:The role of pancreatectomy for very elderly patients with pancreatic adenocarcinoma is controversial. This study aimed to clarify the validity of pancreatic resection in octogenarian patients with pancreatic ductal adenocarcinoma.METHODS:We compared 31 patients aged ≥ 80 years and 548 patients aged < 80 years who underwent pancreatectomy for pancreatic ductal adenocarcinoma and evaluated the relationship between age, clinicopathological factors, recurrence, and outcomes.RESULTS:Postoperative mortality, morbidity, and completion of adjuvant chemotherapy rates did not differ between groups. There were no significant differences in median recurrence-free survival, disease-specific survival, and overall survival between groups (1.0, 2.3, and 2.2 years in patients ≥ 80 years and 1.2, 2.8, and 2.7 years in patients < 80 years; P = 0.67, 0.47, and 0.46, respectively). The median time from recurrence to death of octogenarian patients was significantly shorter than that of younger patients (0.6 vs. 1.1 years, P = 0.0070). In multivariate analysis, age ≥ 80 years (hazard ratio, 1.5), resection of other organs (hazard ratio, 1.8), pathological grade 2/3 (hazard ratio, 1.6), and failure to implement of treatment after recurrence (hazard ratio, 3.6) were independent risk factors for a short time from recurrence to death. Furthermore, age ≥ 80 years (odds ratio, 0.32) was an independent risk factor for the implementation of treatment after recurrence.CONCLUSIONS:Pancreatectomy for octogenarians may be acceptable, but median survival time from recurrence to death was shorter due to lower rates of implementation of treatment after recurrence in octogenarian patients.
DOI 10.1007/s00423-021-02170-4
PMID 33871713