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Oncologic outcomes after radical surgery for periampullary cancer in octogenarians
Ann Hepatobiliary Pancreat Surg 2018 May;22(2):128-35
Published online May 31, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Sung Hyun Kim1, Jae Uk Chong1, Jin Hong Lim1, Moon Jae Chung2, Jeong Youp Park2, Seung Min Bang2, Seung Woo Park2, Ho Kyung Hwang1, Chang Moo Kang1, Woo Jung Lee1, and Kyung Sik Kim1

Departments of 1Hepatobiliary and Pancreatic Surgery and 2Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Received November 9, 2017; Revised February 7, 2018; Accepted February 8, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: Interest in treatments for elderly patients has increased with life expectancy, and various studies have reported on the safety and feasibility of radical surgery in elderly patients with cancer. Here, we investigated oncologic outcomes of periampullary cancer in octogenarians. Methods: We retrospectively reviewed medical records of 68 patients over 80 years of age who were diagnosed with periampullary cancer and were eligible for surgery; we analyzed overall survival (OS) and immediate postoperative complications and mortality. Results: There were no significant differences in mean age, disease type, oncologic features, comorbidities, or nutritional status between the patients who had surgery and those who did not. Five patients (20.0%) had major postoperative complications, but there was no immediate postoperative mortality. Patients who had surgery (n=25) had better OS (29.3 months; 95% confidence interval [CI]: 5.6-53.0) than did those who did not (n=43, OS: 7.6 months; 95% CI: 3.2-12.0 months; p<0.001). Similarly, patients with distal common bile duct cancer who underwent surgery had better OS than those who did not (surgery group: n=13, OS: 29.3 months, 95% CI: 8.9-49.7; non-surgery group: n=15, OS: 5.7 months, 95% CI: 4.2-7.2 months; p=0.002). Conclusions: Radical surgery for octogenarian patients with periampullary cancer is safe, feasible, and expected to result in better survival outcomes, especially for patients with common bile duct cancer. (Ann Hepatobiliary Pancreat Surg 2018;22:128-135)
Keywords : Periampullary cancer; Octogenarian; Radical surgery; Oncologic outcome; Complication