The Impact of Immunonutritional and Physical Status on Surgical Outcome After Pancreaticoduodenectomy in Elderly Patients

Background/Aim: The aim of this study was to determine the significance of immunonutritional and physical index in the assessment of risk associated with pancreaticoduodenectomy (PD) in the elderly. Patients and Methods: This study enrolled 92 patients who underwent PD. They were divided into 2 grou...

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Published inAnticancer research Vol. 39; no. 11; pp. 6347 - 6353
Main Authors SUGIMACHI, KEISHI, IGUCHI, TOMOHIRO, MANO, YOHEI, NISHIJIMA, TOMOHIRO, NAKANOKO, TOMONORI, UEHARA, HIDEO, SUGIYAMA, MASAHIKO, OHTA, MITSUHIKO, IKEBE, MASAHIKO, MORITA, MASARU, TOH, YASUSHI
Format Journal Article
LanguageEnglish
Published Athens International Institute of Anticancer Research 01.11.2019
Subjects
Abdomen
Abdominal surgery
Blood
Body composition
Cohort analysis
Comorbidity
Complications
Fistula
Health risks
Leukocytes (neutrophilic)
Lymphocytes
Malnutrition
Medical prognosis
Morbidity
Mortality
Multivariate analysis
Muscle strength
Musculoskeletal system
Neutrophils
Nutrition assessment
Nutritional status
Older people
Pancreaticoduodenectomy
Postoperative
Proteins
Risk assessment
Sarcopenia
Surgical outcomes
Survival
Japan
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Summary:Background/Aim: The aim of this study was to determine the significance of immunonutritional and physical index in the assessment of risk associated with pancreaticoduodenectomy (PD) in the elderly. Patients and Methods: This study enrolled 92 patients who underwent PD. They were divided into 2 groups: Group A included patients 79 years and younger (n=79) and Group B patients 80 years and older (n=13). Among 37 patients, physical function and body composition were also evaluated. Results: Significantly higher neutrophil–lymphocyte ratio, lower prognostic nutritional index (PNI), and controlling nutritional score were observed in Group B. Muscle strength and walking ability were significantly impaired in Group B, although there was no significant difference in body composition. Age was not correlated with the incidence of postoperative complications, overall survival or recurrence-free survival by univariate and multivariate analysis. Conclusion: PD is justified for the elderly, with acceptable morbidity and prognosis. However, immunonutritional status and physical function are significantly impaired; thus, appropriate case selection and active nutritional support are required for the elderly.
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ISSN:0250-7005
1791-7530
1791-7530
DOI:10.21873/anticanres.13846