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Chirurg ; 84(4): 291-5, 2013 Apr.
Article in German | MEDLINE | ID: mdl-23479275

ABSTRACT

The considerable increase of the aged population in western civilisation within the next years will result in a rising incidence of pancreatic cancer. Until the year 2020 an increment of 20  % of patients beyond 65 years old can be anticipated. Therefore, the focus will be on management of old and geriatric surgical patients leading to strategical re-evaluation of surgical indications under critical consideration of feasibility and purpose. Even under modern interdisciplinary therapy concepts the prognosis of ductal adenocarcinoma of the pancreas remains poor with an overall 5-year survival rate of less than 5  %. The surgical resection is still considered as the only potential curative treatment option with extended life expectancy; however, it is technically demanding and furthermore associated with significant morbidity. In particular, the quality of surgery of the now interdisciplinary therapy of pancreatic cancer is markedly improved when performed at a high-volume centres. Until now only a few retrospective data analyses evaluating the perioperative and long-term outcome after pancreatic tumor resections in geriatric patients exist. The available results, however, support radical surgical procedures even beyond the age of 75 years.


Subject(s)
Carcinoma, Pancreatic Ductal/surgery , Guideline Adherence , Pancreatic Neoplasms/surgery , Patient Care Planning , Age Factors , Aged , Aged, 80 and over , Carcinoma, Pancreatic Ductal/mortality , Carcinoma, Pancreatic Ductal/pathology , Cooperative Behavior , Disease Progression , Female , Germany , Hospitals, High-Volume , Humans , Interdisciplinary Communication , Male , Mesenteric Veins/pathology , Mesenteric Veins/surgery , Neoplasm Invasiveness , Neoplasm Staging , Pancreatectomy/methods , Pancreatectomy/mortality , Pancreatic Neoplasms/mortality , Pancreatic Neoplasms/pathology , Pancreaticoduodenectomy/methods , Pancreaticoduodenectomy/mortality , Portal Vein/pathology , Portal Vein/surgery , Prognosis , Survival Rate , Treatment Outcome
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