title: [Pancreatic cancer in the elderly: guidelines and individualized therapy].
abstract: The considerable increase of the aged population in western civilisation within the next years will result in a rising incidence of pancreatic cancer. Until the year 2020 an increment of 20  % of patients beyond 65 years old can be anticipated. Therefore, the focus will be on management of old and geriatric surgical patients leading to strategical re-evaluation of surgical indications under critical consideration of feasibility and purpose. Even under modern interdisciplinary therapy concepts the prognosis of ductal adenocarcinoma of the pancreas remains poor with an overall 5-year survival rate of less than 5  %. The surgical resection is still considered as the only potential curative treatment option with extended life expectancy; however, it is technically demanding and furthermore associated with significant morbidity. In particular, the quality of surgery of the now interdisciplinary therapy of pancreatic cancer is markedly improved when performed at a high-volume centres. Until now only a few retrospective data analyses evaluating the perioperative and long-term outcome after pancreatic tumor resections in geriatric patients exist. The available results, however, support radical surgical procedures even beyond the age of 75 years.
authors.affiliation: Klinik für Allgemeine, Viszeral-, Transplantations-, Gefäß- und Thoraxchirurgie, LMU München,Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Nieß
authors.forename: A
authors.initials: A
authors.lastname: Kleespies
authors.forename: J
authors.initials: J
authors.lastname: Andrassy
authors.forename: S
authors.initials: S
authors.lastname: Pratschke
authors.forename: P
authors.initials: P
authors.lastname: Pratschke
authors.forename: M K
authors.initials: MK
authors.lastname: Angele
authors.forename: M
authors.initials: M
authors.lastname: Guba
authors.forename: K-W
authors.initials: KW
authors.lastname: Jauch
authors.forename: C J
authors.initials: CJ
authors.lastname: Bruns
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003299:Cooperative Behavior; D018450:Disease Progression; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D061847:Hospitals, High-Volume; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008642:Mesenteric Veins / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods / Q000401:mortality; D010347:Patient Care Planning; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome