title: Radical resection of periampullary tumors in the elderly: evaluation of long-term results.
abstract: Increasingly, patients of advanced age are coming for evaluation of periampullary tumors. Although several studies have demonstrated the safety of resecting periampullary tumors in older patients, few long-term survival data have been reported. Between 1983 and 1992 various periampullary masses were resected in 70 patients over age 65 (range 65-87 years). Total pancreatectomy was performed in 11 patients, and 59 patients underwent pancreaticoduodenectomy. The mean duration of hospitalization was 17 +/- 15 days. Major complications occurred in 27 patients (39%), and operative mortality rate was 8.5%. Overall median survival was 24 months; and 5-year survival was 25%. Perioperative outcome was compared in patients aged 65 to 74 years and in patients > or =75 years old. The older age group required longer periods in the surgical intensive care unit postoperatively, but the long-term survival was similar in the two age groups. Radical resection with the intent to cure periampullary tumors is safe in selected patients of advanced age, and long-term survival is in the range of expected survival for younger patients with the same tumors.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Florida 33136, USA.
authors.forename: O F
authors.initials: OF
authors.lastname: Bathe
authors.forename: D
authors.initials: D
authors.lastname: Levi
authors.forename: H
authors.initials: H
authors.lastname: Caldera
authors.forename: D
authors.initials: D
authors.lastname: Franceschi
authors.forename: L
authors.initials: L
authors.lastname: Raez
authors.forename: A
authors.initials: A
authors.lastname: Patel
authors.forename: W A
authors.initials: WA
authors.lastname: Raub
authors.forename: P
authors.initials: P
authors.lastname: Benedetto
authors.forename: R
authors.initials: R
authors.lastname: Reddy
authors.forename: D
authors.initials: D
authors.lastname: Hutson
authors.forename: D
authors.initials: D
authors.lastname: Sleeman
authors.forename: A S
authors.initials: AS
authors.lastname: Livingstone
authors.forename: J U
authors.initials: JU
authors.lastname: Levi
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000601:surgery*; D016009:Chi-Square Distribution; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome