Pancreatoduodenectomy with portal vein resection is feasible and potentially beneficial for elderly patients with pancreatic cancer.
OBJECTIVE
We aimed to evaluate the feasibility and clinical benefit of pancreatoduodenectomy (PD) with portal vein resection (PVR) in elderly patients.


METHODS
This retrospective study enrolled 272 consecutive patients with pancreatic ductal adenocarcinoma who underwent PD between 2000 and 2012. The patients were categorized into 4 groups: elderly (≥70 years) and younger (<70 years) PD-PVR groups as well as elderly and younger PD groups. Preoperative patient background, postoperative course, and overall survival were compared.


RESULTS
Among the patients who underwent PD-PVR, the elderly group had significantly higher prevalence of comorbidity compared with the younger group (77% and 52%, respectively; P = 0.003), whereas there were no differences in the intraoperative and pathological characteristics. Postoperatively, morbidity and length of hospital stay were similar between the elderly and younger groups. Despite the fact that the proportion of patients who underwent adjuvant chemotherapy was lower in the elderly group (62% vs 83%; P = 0.005), the overall survival of the elderly group was comparable with that of the younger group, and both groups had a significantly more favorable prognosis than that of 36 patients with unresected tumors (P = 0.006 and P < 0.001, respectively).


CONCLUSIONS
Pancreatoduodenectomy with portal vein resection is safe and potentially beneficial for elderly patients with pancreatic cancer.
From the Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan.
Mitsuro
M
Kanda
Tsutomu
T
Fujii
Masaya
M
Suenaga
Hideki
H
Takami
Yoshikuni
Y
Inokawa
Suguru
S
Yamada
Daisuke
D
Kobayashi
Chie
C
Tanaka
Hiroyuki
H
Sugimoto
Shuji
S
Nomoto
Michitaka
M
Fujiwara
Yasuhiro
Y
Kodera
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000601:surgery*; D003967:Diarrhea / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011169:Portal Vein / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome