Postoperative outcomes in elderly patients undergoing pancreatic resection for pancreatic adenocarcinoma: A systematic review and meta-analysis

Tan, Elinor; Song, Jialu; Lam, Susanna; D’Souza, Mario; Crawford, Michael; Sandroussi, Charbel

doi:10.1016/j.ijsu.2019.09.030

Cited by 37 publications

(22 citation statements)

References 73 publications

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“…5,6 Morbidity after surgery is not uncommon in elderly patients and may cause omission of chemotherapy. 25,26,35 Unfortunately, these data were not available in the present study. No distinction was made between neo-and adjuvant chemotherapy because NOR did not provide this.…”

Section: Discussionmentioning

confidence: 90%

“…A recent meta-analysis showed elderly patients have more comorbidities and more overall complications (mainly respiratory), but comparable mortality compared with younger patients. 25 Adequate patient selection, prehabilitation, enhanced recovery protocols, and centralization of pancreatic surgery for elderly patients might improve outcomes. [26][27][28][29][30] Others have advocated a multidisciplinary approach to high-risk elderly patients undergoing major surgery, 31 and several studies have illuminated the importance of geriatric assessment to improve the outcomes of cancer treatment.…”

Section: Discussionmentioning

confidence: 99%

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Treatment and Survival of Elderly Patients with Stage I–II Pancreatic Cancer: A Report of the EURECCA Pancreas Consortium

Groen

Douwes

Eycken³

et al. 2020

Ann Surg Oncol

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Background. Elderly patients with pancreatic cancer are underrepresented in clinical trials, resulting in a lack of evidence. Objective. The aim of this study was to compare treatment and overall survival (OS) of patients aged C 70 years with stage I-II pancreatic cancer in the EURECCA Pancreas Consortium.Methods. This was an observational cohort study of the Belgian (BE), Dutch (NL), and Norwegian (NOR) cancer registries. The primary outcome was OS, while secondary outcomes were resection, 90-day mortality after resection, and (neo)adjuvant and palliative chemotherapy.Previous communication This work was presented as a 'poster in the spotlight' at the 39th

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Treatment and Survival of Elderly Patients with Stage I–II Pancreatic Cancer: A Report of the EURECCA Pancreas Consortium

Groen

Douwes

Eycken³

et al. 2020

Ann Surg Oncol

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“…Usually, the advanced age of patients is considered as a contraindication to PD, because surgery increased the perioperative mortality of patients [5]. However, recently some studies suggest that the surviuval of elderly patients, who underwent PD, was signi cantly longer than those who were not treated by resection of tumor [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

A Time-Trend Survival Analysis of Elderly Resectable Pancreatic Cancer Patients

Jiang

Shang

et al. 2021

Preprint

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Background: The time-trend in the survival of elderly pancreatic cancer patients was still unclear. Thus, the aim of this study was to compare the survival benefit of young and elderly pancreatic cancer patients by a time-trend analysis. Methods: From 2004-2013, we obtained 5,341 of young patients (< 80 years) and 569 elderly patients (≥ 80 years) from the Surveillance, Epidemiology, and End Results (SEER) database, and the overall survival of these patients were analyzed by Kaplan-Meier estimator. The independent factors which could predict the survival of patients were determined by cox proportional hazards model.Results: We observed that the median overall survival of the young patients in 2004-2008 cohort was significantly (P < 0.001) increased when compared to that in the 2009-2013 cohort. However, we did not observe the survival benefit for the elderly patients. The Cox proportional hazards model demonstrated that the tumor size, lymph node ratio, grade, and AJCC TNM stage were independent factors of survival. Conclusions: This study demonstrated that compared to 2004-2008, the survival of elderly patients in 2009-2013 was not significantly improved. Thus, the clinicians still need to administer more care to elderly patients.

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“…The perioperative mortality of pancreatic surgery, especially in high-volume centers, has decreased dramatically to less than 5% in the last two decades (4). However, the rate of the occurrence of postoperative complications remains high (5). The most common complications of PD are postoperative infections, delayed gastric emptying, hemorrhage, and anastomotic insufficiencies (pancreatic, biliary, gastric/duodenal, and enteral) (6,7).…”

Section: Introductionmentioning

confidence: 99%

Rare postoperative hemorrhage after robotic-assisted pancreatoduodenectomy for pancreatic head cancer: a case report

Zhou¹,

Chen²,

Zou³

et al. 2020

J Gastrointest Oncol

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Post-pancreaticoduodenectomy hemorrhage is a life-threatening complication that occurs in 2-10% of patients. The most common location for post-pancreaticoduodenectomy hemorrhage is the gastroduodenal artery stump. Nonetheless, unusual sources of hemorrhage, which are hard to locate, exist. Here, we report a rare postoperative hemorrhage after robotic-assisted pancreatoduodenectomy for pancreatic head cancer. A 67-year-old man presenting with appetite loss, general fatigue and painless jaundice was admitted to our ward. The patient had an elevated level of carbohydrate antigen 19-9 (50 U/mL). Computed tomography scan revealed a 17-mm wide low-density area in the uncinate process of the pancreas. Magnetic resonance cholangiopancreatography showed the dilation of bile and pancreatic ducts. Robotic-assisted pancreaticoduodenectomy was performed on the patient by using the da Vinci Model S Surgical System. On postoperative days 5 and 6, the patient vomited blood, and bloody fluid was observed in the drainage. Emergent gastroscopic examination was performed and revealed a large amount of hematocele in the stomach. On postoperative day 6, emergency operation was undertaken, and the output jejunal loop was found to have intussuscepted in the stomach. This is the first case report of output jejunal loop intussusception in the stomach that consequently caused hemorrhage after robotic-assisted pancreaticoduodenectomy for pancreatic head cancer.

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Postoperative outcomes in elderly patients undergoing pancreatic resection for pancreatic adenocarcinoma: A systematic review and meta-analysis

Cited by 37 publications

References 73 publications

Treatment and Survival of Elderly Patients with Stage I–II Pancreatic Cancer: A Report of the EURECCA Pancreas Consortium

Treatment and Survival of Elderly Patients with Stage I–II Pancreatic Cancer: A Report of the EURECCA Pancreas Consortium

A Time-Trend Survival Analysis of Elderly Resectable Pancreatic Cancer Patients

Rare postoperative hemorrhage after robotic-assisted pancreatoduodenectomy for pancreatic head cancer: a case report

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