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Войти в исследования HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026
Survival after resection compared to no resection among octogenarians with pancreatic and periampullary malignancies: a nationwide study.
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Johansen Karin, Freedman Jacob, Björk Dennis, Sandström Per, Björnsson Bergthor
Аннотация
BACKGROUND: This study aimed to compare survival after surgery among elderly patients with pancreatic and periampullary tumours with patients who were offered resection but declined.
METHODS: Data were obtained from the Swedish national registry for tumours in the pancreatic and periampullary region 2010-2022 for patients ≥80 years. Patients were excluded who were not eligible for upfront resection or who had missing data regarding treatment decision. Remaining patients were compared between one group that underwent surgery and one group that was offered surgery but declined.
RESULTS: Out of 3991 patients, 467 remained after the selection, of whom 360 underwent surgery and 107 declined. Patients who declined surgery were a median two years older and had higher rates of pulmonary disease, peptic ulcer disease and heart failure. Charlson Comorbidity Index was comparable between groups. The median overall survival was 2.2 years after surgery and 0.8 years without surgery. Significant factors in the multivariable analysis for overall survival were surgery, age and diagnosis.
DISCUSSION: The group undergoing surgery had significantly longer overall survival, although this must be interpreted in the light of baseline differences between groups and possible selection bias. This study may serve as an aid for preoperative counseling.
METHODS: Data were obtained from the Swedish national registry for tumours in the pancreatic and periampullary region 2010-2022 for patients ≥80 years. Patients were excluded who were not eligible for upfront resection or who had missing data regarding treatment decision. Remaining patients were compared between one group that underwent surgery and one group that was offered surgery but declined.
RESULTS: Out of 3991 patients, 467 remained after the selection, of whom 360 underwent surgery and 107 declined. Patients who declined surgery were a median two years older and had higher rates of pulmonary disease, peptic ulcer disease and heart failure. Charlson Comorbidity Index was comparable between groups. The median overall survival was 2.2 years after surgery and 0.8 years without surgery. Significant factors in the multivariable analysis for overall survival were surgery, age and diagnosis.
DISCUSSION: The group undergoing surgery had significantly longer overall survival, although this must be interpreted in the light of baseline differences between groups and possible selection bias. This study may serve as an aid for preoperative counseling.