TY - JOUR
T1 - Pancreaticoduodenectomy in elderly adults
T2 - Is it justified in terms of mortality, long-term morbidity, and quality of life?
AU - Gerstenhaber, Fabian
AU - Grossman, Julie
AU - Lubezky, Nir
AU - Itzkowitz, Eran
AU - Nachmany, Ido
AU - Sever, Ronen
AU - Ben-Haim, Menahem
AU - Nakache, Richard
AU - Klausner, Joseph M.
AU - Lahat, Guy
PY - 2013/8
Y1 - 2013/8
N2 - Objectives To evaluate long-term morbidity, mortality, and quality of life (QoL) after pancreaticoduodenectomy (PD) in elderly adults. Design Retrospective cohort study. Setting Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. Participants One hundred and sixty-eight individuals aged 70 and older who underwent PD between 1995 and 2010. Measurements A prospective pancreatic surgery database was analyzed for postoperative morbidity; mortality; intensive care unit (ICU), hospital, and rehabilitation facility stay; and readmissions after surgery. QoL was assessed using a validated questionnaire completed 3, 6, and 12 months after surgery. Results Seventy-two percent of the participants had an American Society of Anesthesiologists score of 3 or greater. There was no intraoperative death. Thirty- and 60-day postoperative mortality rates were 5.9% and 6.5%, respectively. Median ICU stay was 2 days, and median hospital stay was 22 days. Sixty-four participants (37.5%) were discharged to a rehabilitation facility. The first-year readmission rate was 31%. One- and 2-year overall survival rates were 58% and 36%, respectively. Global QoL scores 3 and 12 months after surgery were 68% and 73%, respectively. Scores were lower yet comparable with those of matched individuals undergoing laparoscopic cholecystectomy. Conclusion Most elderly adults with pancreatic cancer survive longer than 1 year after PD; 36% survive longer than 2 years. These individuals are likely to have acceptable long-term morbidity and overall good QoL, corresponding with their age.
AB - Objectives To evaluate long-term morbidity, mortality, and quality of life (QoL) after pancreaticoduodenectomy (PD) in elderly adults. Design Retrospective cohort study. Setting Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. Participants One hundred and sixty-eight individuals aged 70 and older who underwent PD between 1995 and 2010. Measurements A prospective pancreatic surgery database was analyzed for postoperative morbidity; mortality; intensive care unit (ICU), hospital, and rehabilitation facility stay; and readmissions after surgery. QoL was assessed using a validated questionnaire completed 3, 6, and 12 months after surgery. Results Seventy-two percent of the participants had an American Society of Anesthesiologists score of 3 or greater. There was no intraoperative death. Thirty- and 60-day postoperative mortality rates were 5.9% and 6.5%, respectively. Median ICU stay was 2 days, and median hospital stay was 22 days. Sixty-four participants (37.5%) were discharged to a rehabilitation facility. The first-year readmission rate was 31%. One- and 2-year overall survival rates were 58% and 36%, respectively. Global QoL scores 3 and 12 months after surgery were 68% and 73%, respectively. Scores were lower yet comparable with those of matched individuals undergoing laparoscopic cholecystectomy. Conclusion Most elderly adults with pancreatic cancer survive longer than 1 year after PD; 36% survive longer than 2 years. These individuals are likely to have acceptable long-term morbidity and overall good QoL, corresponding with their age.
KW - elderly
KW - long-term morbidity
KW - mortality
KW - pancreaticoduodenectomy
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=84882238107&partnerID=8YFLogxK
U2 - 10.1111/jgs.12360
DO - 10.1111/jgs.12360
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C2 - 23865843
AN - SCOPUS:84882238107
SN - 0002-8614
VL - 61
SP - 1351
EP - 1357
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 8
ER -