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Postoperative functional results of older patients after pancreas and liver surgery
Affiliations- Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, I Chair of General Surgery, Jagiellonian University Medical College, Krakow, Poland
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Abstract
In clinical observational studies, overall survival and cancer-specific survival are usually considered the gold standard endpoints. Equally or even more important for older patients are patient-reported outcomes, defined as a set of patient-centered measures that evaluate physical, mental, and social health.
This is particularly important due to the complexity of surgical treatment and the higher risk of postoperative morbidity and mortality. The studies showed that after these operations, the quality of life (QoL) decreases and that is improving with time. After 6 months there was no difference in QoL between younger and older patients. Nevertheless, the results refer mostly to the group of patients who survived the follow-up period and had no recurrence. Therefore, age itself should not be a contraindication for pancreatic or liver surgery. QoL of patients not qualified for surgery decreased constantly.
Abstract
In clinical observational studies, overall survival and cancer-specific survival are usually considered the gold standard endpoints. Equally or even more important for older patients are patient-reported outcomes, defined as a set of patient-centered measures that evaluate physical, mental, and social health.
This is particularly important due to the complexity of surgical treatment and the higher risk of postoperative morbidity and mortality. The studies showed that after these operations, the quality of life (QoL) decreases and that is improving with time. After 6 months there was no difference in QoL between younger and older patients. Nevertheless, the results refer mostly to the group of patients who survived the follow-up period and had no recurrence. Therefore, age itself should not be a contraindication for pancreatic or liver surgery. QoL of patients not qualified for surgery decreased constantly.
Keywords
older patients; frailty; functional results; quality of life
About this articleTitle
Postoperative functional results of older patients after pancreas and liver surgery
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Review paper
Pages
202-206
Published online
2022-05-23
Page views
4435
Article views/downloads
362
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2022;72(3):202-206.
Keywords
older patients
frailty
functional results
quality of life
Authors
Jakub Kenig
Jerzy Krzeszowiak
Kuba Kupniewski
References (21)- Rostoft S, Audisio RA. Recent advances in cancer surgery in older patients. Research. 2017; 6(F1000 Faculty Rev): 1242.
- Kenig J. Oncogeriatrics (part 1.). Frailty in older adults with cancer. Nowotwory. Journal of Oncology. 2019; 69(2): 55–57.
- Kenig J, Szabat K, Mituś J, et al. Short- and long-term predictive power of the preoperative Geriatric Assessment components in older cancer patients undergoing high-risk abdominal surgery. Eur J Surg Oncol. 2022 [Epub ahead of print].
- Kenig J, Szabat K. Oncogeriatrics (part 7.). Geriatric assessment for older patients with cancer. Nowotwory. Journal of Oncology. 2020; 70(4): 153–157.
- Grodzicki T, Kenig J. Problemy okołooperacyjne u osób w wieku podeszłym. PZWL Wydawnictwo Lekarskie 2018.
- Kenig J. Hepatocellular cancer and colorectal liver metastasis treatment in the older population. Nowotwory. Journal of Oncology. 2022; 72(1): 52–57.
- Kenig J, Richter P. Pancreatoduodenectomy due to cancer in the older population. Nowotwory. Journal of Oncology. 2021; 71(5): 321–327.
- Knight J, Ayyash K, Colling K, et al. A cohort study investigating the relationship between patient reported outcome measures and pre-operative frailty in patients with operable, non-palliative colorectal cancer. BMC Geriatr. 2020; 20(1): 311.
- Gerstenhaber F, Grossman J, Lubezky N, et al. Pancreaticoduodenectomy in elderly adults: is it justified in terms of mortality, long-term morbidity, and quality of life? J Am Geriatr Soc. 2013; 61(8): 1351–1357.
- Kim E, Lee DH, Jang JY. Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study. Gut Liver. 2019; 13(6): 690–697.
- Parray A, Bhandare MS, Pandrowala S, et al. Peri-operative, long-term, and quality of life outcomes after pancreaticoduodenectomy in the elderly: greater justification for periampullary cancer compared to pancreatic head cancer. HPB (Oxford). 2021; 23(5): 777–784.
- Torphy RJ, Chapman BC, Friedman C, et al. Quality of Life Following Major Laparoscopic or Open Pancreatic Resection. Ann Surg Oncol. 2019; 26(9): 2985–2993.
- Watanabe Y, Ohtsuka T, Matsunaga T, et al. Long-term outcomes after total pancreatectomy: special reference to survivors' living conditions and quality of life. World J Surg. 2015; 39(5): 1231–1239.
- Bruns H, Krätschmer K, Hinz U, et al. Quality of life after curative liver resection: a single center analysis. World J Gastroenterol. 2010; 16(19): 2388–2395.
- Poon RT, Fan ST, Yu WC, et al. A prospective longitudinal study of quality of life after resection of hepatocellular carcinoma. Arch Surg. 2001; 136(6): 693–699.
- Mise Y, Satou S, Ishizawa T, et al. Impact of surgery on quality of life in patients with hepatocellular carcinoma. World J Surg. 2014; 38(4): 958–967.
- Riffat F, Chu F, Morris DL. Liver resection in octogenarians. HPB (Oxford). 2006; 8(3): 206–210.
- Pequeno NP, Cabral NL, Marchioni DM, et al. Quality of life assessment instruments for adults: a systematic review of population-based studies. Health Qual Life Outcomes. 2020; 18(1): 208.
- Chen G, Zhang J, Sun J, et al. Revisiting Partial Hepatectomy of Large Hepatocellular Carcinoma in Older Patients. Sci Rep. 2018; 8(1): 14505.
- Nomi T, Hirokawa F, Kaibori M, et al. Laparoscopic versus open liver resection for hepatocellular carcinoma in elderly patients: a multi-centre propensity score-based analysis. Surg Endosc. 2020; 34(2): 658–666.
- Mise Y, Satou S, Ishizawa T, et al. Impact of surgery on quality of life in patients with hepatocellular carcinoma. World J Surg. 2014; 38(4): 958–967.