TY - JOUR
T1 - Optimal Treatment for Octogenarians with Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma
T2 - A Multicenter Retrospective Study
AU - Satoi, Sohei
AU - Yamamoto, Tomohisa
AU - Uchida, Kazushige
AU - Fujii, Tsutomu
AU - Kin, Toshifumi
AU - Hirano, Satoshi
AU - Hanada, Keiji
AU - Itoi, Takao
AU - Murakami, Yoshiaki
AU - Igarashi, Hisato
AU - Eguchi, Hidetoshi
AU - Kuroki, Tamotsu
AU - Shimizu, Yasuhiro
AU - Tani, Masaji
AU - Tanno, Satoshi
AU - Tsuji, Yoshihisa
AU - Hirooka, Yoshiki
AU - Masamune, Atsushi
AU - Shimokawa, Toshio
AU - Yamaue, Hiroki
AU - Okazaki, Kazuichi
N1 - Funding Information:
From the *Department of Surgery, Kansai Medical University, Osaka; †Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi; ‡Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama; §Center for Gastroenterology, Teine-Keijinkai Hospital; ||Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo; ¶Department of Gastroenterology, JA Onomichi General Hospital, Hiroshima; #Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo; **Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima; ††Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka; ‡‡Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka; §§Department of Surgery, National Hospital Nagasaki Medical Center, Nagasaki; ||||Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya; ¶¶Department of Surgery, Shiga University of Medical Science, Otsu; ##Department of Gastroenterology, IMS Sapporo Digestive Center General Hospital, Sapporo; ***Department of Clinical Education, Shiga University of Medical Science, Otsu; †††Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University, Aichi; ‡‡‡Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai; §§§Clinical Study Support Center, and ||||||Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama; and ¶¶¶Department of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan. Received for publication November 6, 2019; accepted April 21, 2020. Address correspondence to: Hiroki Yamaue, MD, Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan (e‐mail: yamaue-h@wakayama-med.ac.jp). This study was supported by the Japan Pancreas Society. The authors declare no conflicts of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.pancreasjournal.com). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MPA.0000000000001579 Significant independent prognostic factors were body mass index, lymph node metastasis, and tumor diameter in the surgery group, and serum albumin level, American Society of Anesthesiologists classification, body mass index, modified Glasgow prognostic score, second-line chemotherapy, and tumor diameter in the chemotherapy group. Conclusions: Octogenarians with resectable/borderline resectable pancreatic ductal adenocarcinoma can be recommended for pancreatectomy according to mental and physical fitness for surgical procedures.
Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Objectives The objective of this study was to clarify the role of pancreatectomy for patients with resectable and borderline resectable pancreatic ductal adenocarcinoma aged 80 years or older using a nationwide audit by the Japan Pancreas Society. Methods Data were collected from 39 institutions from 2007 to 2014. The primary endpoint was overall survival, and secondary endpoints were surgical outcomes and predictive factors for prognosis. Results Data were obtained from 556 octogenarians who underwent pancreatectomy (n = 369, 66%), chemo(radio)therapy (n = 99, 18%), and palliative therapy (n = 88, 16%). Median survival times were 20.6, 18.6, and 8.8 months in each group, respectively. Even after propensity score matching, median survival time in the surgery group (22.8 months) was significantly higher than that in the chemotherapy group (18.5 months; hazard ratio, 0.64 [95% confidence interval, 0.44-0.93]; P = 0.020). Significant independent prognostic factors were body mass index, lymph node metastasis, and tumor diameter in the surgery group, and serum albumin level, American Society of Anesthesiologists classification, body mass index, modified Glasgow prognostic score, second-line chemotherapy, and tumor diameter in the chemotherapy group. Conclusions Octogenarians with resectable/borderline resectable pancreatic ductal adenocarcinoma can be recommended for pancreatectomy according to mental and physical fitness for surgical procedures.
AB - Objectives The objective of this study was to clarify the role of pancreatectomy for patients with resectable and borderline resectable pancreatic ductal adenocarcinoma aged 80 years or older using a nationwide audit by the Japan Pancreas Society. Methods Data were collected from 39 institutions from 2007 to 2014. The primary endpoint was overall survival, and secondary endpoints were surgical outcomes and predictive factors for prognosis. Results Data were obtained from 556 octogenarians who underwent pancreatectomy (n = 369, 66%), chemo(radio)therapy (n = 99, 18%), and palliative therapy (n = 88, 16%). Median survival times were 20.6, 18.6, and 8.8 months in each group, respectively. Even after propensity score matching, median survival time in the surgery group (22.8 months) was significantly higher than that in the chemotherapy group (18.5 months; hazard ratio, 0.64 [95% confidence interval, 0.44-0.93]; P = 0.020). Significant independent prognostic factors were body mass index, lymph node metastasis, and tumor diameter in the surgery group, and serum albumin level, American Society of Anesthesiologists classification, body mass index, modified Glasgow prognostic score, second-line chemotherapy, and tumor diameter in the chemotherapy group. Conclusions Octogenarians with resectable/borderline resectable pancreatic ductal adenocarcinoma can be recommended for pancreatectomy according to mental and physical fitness for surgical procedures.
KW - borderline resectable PDAC
KW - octogenarian
KW - overall survival
KW - pancreatic ductal adenocarcinoma
KW - resectable PDAC
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U2 - 10.1097/MPA.0000000000001579
DO - 10.1097/MPA.0000000000001579
M3 - Article
C2 - 32590619
AN - SCOPUS:85087135346
SN - 0885-3177
VL - 49
SP - 837
EP - 844
JO - Pancreas
JF - Pancreas
IS - 6
ER -
