ASO Visual Abstract: Short- and Long-Term Outcomes of Pancreatic Cancer Resection for Elderly Patients: A Nationwide Analysis (original) (raw)
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Annals of Surgical Oncology, 2022
Background. The number of elderly patients with pancreatic cancer is growing, however clinical data on the short-term outcomes, rate of adjuvant chemotherapy, and survival in these patients are limited and we therefore performed a nationwide analysis. Methods. Data from the prospective Dutch Pancreatic Cancer Audit were analyzed, including all patients undergoing pancreatic cancer resection between January 2014 and December 2016. Patients were classified into two age groups: \75 and C75 years. Major complications (Clavien-Dindo grade 3 or higher), 90-day mortality, rates of adjuvant chemotherapy, and survival were compared between age groups. Factors associated with start of adjuvant chemotherapy and survival were evaluated with logistic regression and multivariable Cox regression analysis. Results. Of 836 patients, 198 were aged C75 years (24%) and 638 were aged \75 years (76%). Median follow-up I. Quintus Molenaar and Hjalmar C. van Santvoort share senior authorship.
Pancreatic Cancer: 80 Years of Surgery—Percentage and Repetitions
HPB Surgery, 2016
Objective. The incidence of pancreatic cancer is estimated to be 48,960 in 2015 in the US and projected to become the second and third leading causes of cancer-related deaths by 2030. The mean costs in 2015 may be assumed to be 79,800perpatientandforeachresection79,800 per patient and for each resection 79,800perpatientandforeachresection164,100. Attempt is made to evaluate the results over the last 80 years, the number of survivors, and the overall survival percentage.Methods. Altogether 1230 papers have been found which deal with resections and reveal survival information. Only 621 of these report 5-year survivors. Reservation about surgery was first expressed in 1964 and five-year survival of nonresected survivors is well documented.Results. The survival percentage depends not only on the number of survivors but also on the subset from which it is calculated. Since the 1980s the papers have mainly reported the number of resections and survival as actuarial percentages, with or without the actual number of survivors being reported. The actuarial p...
Surgical Treatment of Pancreatic Cancer
Annals of the New York Academy of Sciences, 2008
Despite many years of continuous effort, pancreatic carcinoma remains a highly lethal disease and a challenge to the medical community. Most patients will be diagnosed in an advanced stage of the disease and will be candidates for oncological palliative therapy or supportive care only. These patient groups have a life expectancy of only a few months. It is documented that less than one of these patients will be alive after five years. 1,2 Surgical resection remains the only hope for long-term survival, but this option is available only for patients with a tumour confined to the pancreas. In population studies, 5-12% of patients were candidates for pancreatic resection. 3-6
Clinical and pathologic prognostic factors for curative resection for pancreatic cancer
HPB, 2008
Background. Pancreatic cancer is the fifth leading cause of cancer-related deaths in the world. Operative resection is the only therapeutic option with curative potential for this disease. Objective. The aim of the present study was to correlate clinical and pathologic parameters with survival in patients submitted to pancreatic resection for pancreatic adenocarcinoma. Methods. Surgical resection with curative intent (R0 and R1 resections) was performed in 65 pancreatic cancer patients between 1990 and 2006. The overall results of surgical treatment were retrospectively analyzed and compared with the clinicopathologic features of these patients. Results. Pylorus-preserving pancreatoduodenectomy was performed in 37 patients (56.9%), classic resection in 35.4%, distal pancreatectomy in 4.6% and total pancreatectomy in 3.6%. The inhospital mortality was 5% (three patients). Postoperative complications occurred in 28 patients (43%). Mean survival and five-year survival rate after curative resection were 27 months and 9.0%, respectively. Sex, TNM stage, tumor differentiation, neural invasion, tumor size and involvement of resection margin were significant prognostic factors on univariate analysis. Multivariate analysis showed tumor differentiation and neural invasion as prognostic factors. Conclusion. Patients with pancreatic cancer, even those with poor prognostic factors should be given the opportunity of surgical resection with curative intent.