A Study for Limit of the Extended Radical Operation for Ductal Adenocarcinoma of the Head of the Pancreas in Aged Patients

Takashi Hatori, Toshihide Imaizumi, Toshiaki Nakasako, Nobuhiko Harada, Tadashi Suzuki, Nobuo Tenma, Fujio Hanyu, Ken Takasaki

Department of Gastroenterological Surgery, Tokyo Women's Medical College

This study was undertaken to evaluate the indications for and limits of extended radical operation for aged patients, 70 years and older, with ductal adenocarcinoma of the head of the pancreas. A total of 150 patients who underwent radical resection were analyzed in this study and divided into three groups, those 80 years of age and more (n=5), those from 70 to 79 years of age (n=62) and those from 60 to 69 years of age (n=83%). The resectability rate among those 80 years of age and more was lower (28%) than those for patients from 70 to 79 years of age 54%) and 60 to 69 years of age (58%). However, the reason for tumors being unresectable was advanced extension in all three groups. The extended radical operation was performed for at least 80% of patients in all three groups and there were no statistically significant differences among the three groups in postoperative morbidity, but the rate of hospital death was 13% among those from 70 to 79 years of age. Tumor extension was quite severe with retroperitoneal invasion and lymph node metastasis in all three groups. The 5-year survival rate with curability A or B in those from 70 to 79 years of age was 21% and there were three longterm survivors (more than 5 years). However, in all cases 80 years of age and more the curability was C and the longest survival time only 11 months. It was concluded that aged patients, 70 years of age and older, with an expected curability of A or B are indicated for extended radical operation of ductal adenocarcinoma of the head of the pancreas.

Key words
aged patients, pancreatic head cancer, extended radical operation

Reprint requests
Takashi Hatori Department of Gastroenterological Surgery, Tokyo Women's Medical College
8-1 Kawada-cho, Sinjuku-ku, Tokyo, 162 JAPAN

Accepted
June 12, 1996

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