open access

Vol 71, No 5 (2021)
Review paper
Published online: 2021-10-13
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Pancreatoduodenectomy due to cancer in the older population

Jakub Kenig1, Piotr Richter1
DOI: 10.5603/NJO.2021.0061
·
Nowotwory. Journal of Oncology 2021;71(5):321-327.
Affiliations
  1. Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, I Chair of General Surgery, Jagiellonian University Medical College, Krakow, Poland

open access

Vol 71, No 5 (2021)
Oncogeriatrics
Published online: 2021-10-13

Abstract

By 2030, 70% of all pancreatic cancer will be diagnosed in the older population. However, pancreas operations are a complex surgical procedure with a high rate of morbidity and mortality. Therefore, the benefits of surgical resection in older patients are controversial and decisions about treatment for this group must be well balanced. Chronological age alone should not be a contraindication for multimodal radical treatment in older patients. Fit patients, according to the comprehensive geriatric assessment (SGA), should be qualified for the same treatment as younger patients to benefit the same outcomes. However, they should be operated on in high-volume hospitals by experienced surgeons. Prefrail patients should undergo prehabilitation, during neoadjuvant treatment also, and then reevaluated. Frail patients should be discussed in an oncogeriatric meeting. We still do not have evidence-based data to design a tailored approach for them so as to balanced good oncologic outcomes and the appropriate postoperative quality of life.

Abstract

By 2030, 70% of all pancreatic cancer will be diagnosed in the older population. However, pancreas operations are a complex surgical procedure with a high rate of morbidity and mortality. Therefore, the benefits of surgical resection in older patients are controversial and decisions about treatment for this group must be well balanced. Chronological age alone should not be a contraindication for multimodal radical treatment in older patients. Fit patients, according to the comprehensive geriatric assessment (SGA), should be qualified for the same treatment as younger patients to benefit the same outcomes. However, they should be operated on in high-volume hospitals by experienced surgeons. Prefrail patients should undergo prehabilitation, during neoadjuvant treatment also, and then reevaluated. Frail patients should be discussed in an oncogeriatric meeting. We still do not have evidence-based data to design a tailored approach for them so as to balanced good oncologic outcomes and the appropriate postoperative quality of life.

Get Citation

Keywords

older patients; pancreatic cancer; pancreatoduodenectomy; elderly

About this article
Title

Pancreatoduodenectomy due to cancer in the older population

Journal

Nowotwory. Journal of Oncology

Issue

Vol 71, No 5 (2021)

Article type

Review paper

Pages

321-327

Published online

2021-10-13

DOI

10.5603/NJO.2021.0061

Bibliographic record

Nowotwory. Journal of Oncology 2021;71(5):321-327.

Keywords

older patients
pancreatic cancer
pancreatoduodenectomy
elderly

Authors

Jakub Kenig
Piotr Richter

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