Pancreaticoduodenectomy in patients < 75 years versus ≥ 75 years old: a comparative study.

IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Muhammer Ergenç, Tevfik Kıvılcım Uprak, Ayşegül Bahar Özocak, Şakir Karpuz, Mümin Coşkun, Cumhur Yeğen, Ali Emre Atıcı
{"title":"Pancreaticoduodenectomy in patients < 75 years versus ≥ 75 years old: a comparative study.","authors":"Muhammer Ergenç, Tevfik Kıvılcım Uprak, Ayşegül Bahar Özocak, Şakir Karpuz, Mümin Coşkun, Cumhur Yeğen, Ali Emre Atıcı","doi":"10.1007/s40520-024-02804-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the postoperative outcomes of < 75-year-old patients and ≥ 75-year-old patients who underwent pancreaticoduodenectomy (PD) for pancreatic head and periampullary region tumors.</p><p><strong>Methods: </strong>Patients who underwent PD in our hospital between February 2019 and December 2023 were evaluated. Demographics, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores, American Society of Anesthesiologists (ASA) scores, comorbidities, hospital stays, complications, and clinicopathological features were analyzed. Patients were divided into < 75 years (Group A) and ≥ 75 years (Group B) groups and compared.</p><p><strong>Results: </strong>The median age of the entire cohort (n = 155) was 66 years (IQR = 16). There was a significant difference between Group A (n = 128) and Group B (n = 27) regarding the ECOG-PS and ASA scores. There was no significant difference between the groups regarding postoperative complications. The 30-day mortality rate was greater in Group B (p = 0.017). Group B had a cumulative median survival of 10 months, whereas Group A had a median survival of 28 months, with a statistically significant difference (p < 0.001). When age groups were stratified according to ECOG-PS, for ECOG-PS 2-3 Group A, survival was 15 months; for ECOG-PS 2-3 Group B, survival was eight months, and the difference was not statistically significant (p = 0.628).</p><p><strong>Conclusions: </strong>With the increasing aging population, patient selection for PD should not be based solely on age. This study demonstrated that PD is safe for patients older than 75 years. In older patients, performance status and the optimization of comorbidities should be considered when deciding on a candidate's suitability for surgery.</p>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224114/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aging Clinical and Experimental Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40520-024-02804-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: This study aimed to compare the postoperative outcomes of < 75-year-old patients and ≥ 75-year-old patients who underwent pancreaticoduodenectomy (PD) for pancreatic head and periampullary region tumors.

Methods: Patients who underwent PD in our hospital between February 2019 and December 2023 were evaluated. Demographics, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores, American Society of Anesthesiologists (ASA) scores, comorbidities, hospital stays, complications, and clinicopathological features were analyzed. Patients were divided into < 75 years (Group A) and ≥ 75 years (Group B) groups and compared.

Results: The median age of the entire cohort (n = 155) was 66 years (IQR = 16). There was a significant difference between Group A (n = 128) and Group B (n = 27) regarding the ECOG-PS and ASA scores. There was no significant difference between the groups regarding postoperative complications. The 30-day mortality rate was greater in Group B (p = 0.017). Group B had a cumulative median survival of 10 months, whereas Group A had a median survival of 28 months, with a statistically significant difference (p < 0.001). When age groups were stratified according to ECOG-PS, for ECOG-PS 2-3 Group A, survival was 15 months; for ECOG-PS 2-3 Group B, survival was eight months, and the difference was not statistically significant (p = 0.628).

Conclusions: With the increasing aging population, patient selection for PD should not be based solely on age. This study demonstrated that PD is safe for patients older than 75 years. In older patients, performance status and the optimization of comorbidities should be considered when deciding on a candidate's suitability for surgery.

Abstract Image

胰十二指肠切除术在 75 岁以下和 75 岁以上患者中的应用:一项比较研究。
目的本研究旨在比较腹腔镜手术的术后效果:对 2019 年 2 月至 2023 年 12 月期间在我院接受 PD 的患者进行评估。对人口统计学、东部合作肿瘤学组表现状态(ECOG-PS)评分、美国麻醉医师协会(ASA)评分、合并症、住院时间、并发症和临床病理特征进行分析。结果整个组群(n = 155)的中位年龄为 66 岁(IQR = 16)。在 ECOG-PS 和 ASA 评分方面,A 组(n = 128)和 B 组(n = 27)之间存在明显差异。两组在术后并发症方面无明显差异。B 组的 30 天死亡率更高(P = 0.017)。B 组的累积中位存活期为 10 个月,而 A 组的中位存活期为 28 个月,两组间差异有统计学意义(P 结论:B 组的累积中位存活期为 10 个月,而 A 组的累积中位存活期为 28 个月:随着人口老龄化的加剧,选择腹膜透析患者时不应仅考虑年龄因素。本研究表明,PD 对 75 岁以上的患者是安全的。在决定患者是否适合手术时,应考虑老年患者的表现状况和合并症的优化情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
7.90
自引率
5.00%
发文量
283
审稿时长
1 months
期刊介绍: Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信