In pancreatic cancer, surgery in elderly linked to better survival

  • Park HM & al.
  • BMC Cancer
  • 12 Nov 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • In a small retrospective analysis, surgery is associated with better survival rates than no surgery in elderly patients with pancreatic cancer.

Why this matters

  • Elderly patients have traditionally not undergone surgery because of fears of complications, but recent studies showed no difference in 90-day mortality or severe morbidity among elderly patients.

Study design

  • Retrospective analysis of records from the National Cancer Center in Korea (n=49; age, ≥75 years; 38 surgery; 11 no surgery).
  • Funding: None.

Key results

  • Surgeries: Whipple's operation (6 surgeries), pylorus-preserving pancreaticoduodenectomy (16 surgeries), total pancreatectomy (4 surgeries), distal pancreatectomy (12 surgeries).
  • No surgery group: 3 could not undergo surgery because of poor health, 8 declined surgery or other treatment.
  • The surgery group had a higher median survival time after diagnosis (17±5.5 vs 10±2.8 months).
  • A univariate analysis showed not undergoing surgical resection to be a risk factor for OS (HR, 2.412; P=.022), along with a high Charlson comorbidity index (HR, 5.252; P=.014).
  • 2-year survival was 40.7% in the surgery group and 0% in the no-surgery group (P=.015).
  • Median survival was higher in the surgery group: 22 vs 14 months.
  • 31.6% had C-D classification III/IV postoperative complications.

Limitations

  • Retrospective analysis.
  • Korean population.