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シイハラ マサヒロ
椎原 正尋 所属 医学部 医学科（東京女子医科大学病院） 職種 助教 |
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| 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 |
| 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 |