PDF(Pubmed)
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.
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.
摘要：
目的：本研究旨在比较<75岁患者和≥75岁患者因胰头和壶腹周围区肿瘤行胰十二指肠切除术（PD）的术后结局。
方法：评估了2019年2月至2023年12月在我院接受PD的患者。人口统计,东部肿瘤协作组绩效状态（ECOG-PS）得分，美国麻醉医师协会（ASA）评分，合并症,住院,并发症,并对临床病理特征进行分析。将患者分为<75岁组（A组）和≥75岁组（B组）并进行比较。
结果：整个队列（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）之间存在显着差异。两组之间在术后并发症方面没有显着差异。B组的30天死亡率更高（p=0.017）。B组的累积中位生存期为10个月，而A组的中位生存期为28个月，具有统计学上的显著差异(p<0.001)。当根据ECOG-PS对年龄组进行分层时，对于ECOG-PS2-3A组，生存期为15个月；对于ECOG-PS2-3B组，存活了八个月,差异无统计学意义(p=0.628)。
结论：随着人口老龄化，PD患者的选择不应仅仅基于年龄.这项研究表明，PD对75岁以上的患者是安全的。在老年患者中，在决定候选人是否适合手术时，应考虑表现状况和合并症的优化。
方法：评估了2019年2月至2023年12月在我院接受PD的患者。人口统计,东部肿瘤协作组绩效状态（ECOG-PS）得分，美国麻醉医师协会（ASA）评分，合并症,住院,并发症,并对临床病理特征进行分析。将患者分为<75岁组（A组）和≥75岁组（B组）并进行比较。
结果：整个队列（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）之间存在显着差异。两组之间在术后并发症方面没有显着差异。B组的30天死亡率更高（p=0.017）。B组的累积中位生存期为10个月，而A组的中位生存期为28个月，具有统计学上的显著差异(p<0.001)。当根据ECOG-PS对年龄组进行分层时，对于ECOG-PS2-3A组，生存期为15个月；对于ECOG-PS2-3B组，存活了八个月,差异无统计学意义(p=0.628)。
结论：随着人口老龄化，PD患者的选择不应仅仅基于年龄.这项研究表明，PD对75岁以上的患者是安全的。在老年患者中，在决定候选人是否适合手术时，应考虑表现状况和合并症的优化。
