Long-term outcomes of combined treatment of primary resectable pancreatic head cancer in patients over 70 years

Abstract

   Aim. To evaluate long-term oncological outcomes of pancreatoduodenectomy in resectable pancreatic head cancer in patients over 70 years of age.   Materials and methods. A retrospective analysis of the Moscow Clinical Scientific Center registry revealed 63 patients aged > 70 years with resectable  pancreatic head cancer. In 2016–2023, these patients underwent pancreatoduodenectomy. Males accounted for 35 %, and the median age comprised 75 years. Stage II was diagnosed in 44.4 % of patients, stage I – in 31.7 %, and stage III – in 23.8 %. Median follow-up accounted for 34.5 months. The authors analyzed the effect of patient characteristics, tumor, perioperative data and method of surgery on overall survival.   Results. Adjuvant chemotherapy (p = 0.005; HR 0.28, CI 0.115–0.62) and low preoperative albumin levels (p = 0.004; HR 0.203, CI 0.28–0.61) had a significant impact on overall survival. After open surgery, 56 % of patients did not receive adjuvant chemotherapy, after minimally invasive surgery – 15.4 % (p = 0.0001).   Conclusion. Minimally invasive pancreatoduodenectomy reveals no negative effect on the oncological outcomes of treatment for resectable pancreatic head cancer in patients ≥ 70 years old. Adjuvant chemotherapy and hypoalbuminemia prior to surgery are considered to be statistically significant factors influencing overall survival. Minimally invasive techniques enable adjuvant chemotherapy to be administered to a larger number of patients compared to open intervention.