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Can we recommend surgical treatment to the octogenarian with periampullary cancer?: National database analysis in South Korea

Authors
 Chang M Kang  ;  Jin H Lee  ;  Jung K Choi  ;  Ho K Hwang  ;  Jae U Chung  ;  Woo J Lee  ;  Kuk H Kwon 
Citation
 EUROPEAN JOURNAL OF CANCER, Vol.144 : 81-90, 2020-12 
Journal Title
 EUROPEAN JOURNAL OF CANCER 
ISSN
 0959-8049 
Issue Date
2020-12
Keywords
Elderly ; Octogenarian ; Pancreaticoduodenectomy ; Periampullary cancer ; Survival
Abstract
Background: The incidence of periampullary cancer in the elderly is increasing. Safety and oncologic effectiveness of pancreaticoduodenectomy in elderly patients is still controversial. Materials and methods: From 2002 to 2016, patients with periampullary cancer were evaluated. Customised health information data provided by the National Health Insurance Corporation (NHIS-2018-1-157) were used for analysis. Chronological changes in the incidence of periampullary cancer and long-term survival outcomes were estimated according to patients' age. Result: A total of 148,080 patients were found to have periampullary cancer. Chronologically, the incidence of periampullary cancer increased, and the proportion of elderly patients with periampullary cancer prominently increased (about 2.1 times in patients in their 70s and about 4.7 times in those older than 80 years). The number of patients with pylorus-preserving pancreaticoduodenectomy in their 70s (about 5.6 times, p < 0.001) and over 80 years of age (about 8.9 times, p < 0.001) was much higher than the number of patients aged younger than 50 years (about 1.7 times) and in their 60s (about 2.5 times). Long-term survival was different as per diagnosis (p < 0.001). In addition, it was observed that age was a factor attenuating the survival of patients with resected periampullary cancers (p < 0.001). However, in case of patients older than 80 years, those who underwent surgical treatment showed a higher survival rate than those who did not undergo surgical treatment. Conclusion: We can recommend surgical treatment for elderly patients with resectable periampullary cancer. The survival data in this study can be useful references especially in making treatment plan for octogenarians diagnosed with periampullary cancer.
Full Text
https://www.sciencedirect.com/science/article/pii/S0959804920313289
DOI
10.1016/j.ejca.2020.10.039
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181389
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