World Journal of Surgery

, Volume 30, Issue 11, pp 1992–2001

Prognostic Factors in Periampullary and Pancreatic Tumor Resection in Elderly Patients

  • R. Casadei
  • N. Zanini
  • A. M. Morselli-Labate
  • L. Calculli
  • R. Pezzilli
  • O. Potì
  • T. Grottola
  • C. Ricci
  • F. Minni
Article

DOI: 10.1007/s00268-006-0122-5

Cite this article as:
Casadei, R., Zanini, N., Morselli-Labate, A.M. et al. World J. Surg. (2006) 30: 1992. doi:10.1007/s00268-006-0122-5

Abstract

Background

More than half of all patients with pancreatic adenocarcinoma are over 70 years of age. Life expectancy for the elderly population is increasing and currently major pancreatic resection provides the only meaningful chance of cure for periampullary and pancreatic tumors. Controversy over what constitutes the correct treatment of these tumors in elderly patients continues to this day. The aim of our study was to determine whether age alone or age plus some prognostic factors constitute contraindications to major pancreatic resections.

Methods

Between 2000 and 2005, data from 88 consecutive patients who had major pancreatic resection for periampullary or pancreatic tumors were entered into a prospective database. Fifty-three patients under 70 years of age (young patients), and 35 patients 70 years of age or older (elderly patients) were compared with respect to several characteristics and the postoperative course.

Results

Postoperative mortality and morbidity, length of hospital stay, and long-term survival were similar in the two groups. In the elderly group, the mortality rate was significantly higher in patients with chronic obstructive pulmonary disease (COPD), and the morbidity rate was significantly higher in patients with ASA 3 than in patients with ASA 1–2, in whom a pancreaticoduodenectomy or total pancreatectomy had been performed.

Conclusions

Age alone is not a contraindication for major pancreatic resection. In elderly patients a careful evaluation of the co-morbidities and of the type of surgical procedure is mandatory in order to allow the proper selection of those patients best suited for surgery in specialized centers.

Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

  • R. Casadei
    • 1
  • N. Zanini
    • 1
  • A. M. Morselli-Labate
    • 3
  • L. Calculli
    • 2
  • R. Pezzilli
    • 3
  • O. Potì
    • 1
  • T. Grottola
    • 1
  • C. Ricci
    • 1
  • F. Minni
    • 1
  1. 1.Dipartimento di Scienze Chirurgiche e AnestesiologicheAlma Mater Studiorum-Università di Bologna, Policlinico S. Orsola-MalpighiBolognaItaly
  2. 2.Dipartimento di Scienze Radiologiche e IstocitopatologicheAlma Mater Studiorum-Università di Bologna, Policlinico S. Orsola-MalpighiBolognaItaly
  3. 3.Dipartimento di Medicina Interna e GastroenterologiaAlma Mater Studiorum-Università di Bologna, Policlinico S. Orsola-MalpighiBolognaItaly