scholarly journals Propensity score-matching analysis comparing minimally invasive and open distal pancreatectomy in elderly patients and application of the modified frailty index

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S827
Author(s):  
G. Montagnini ◽  
M. De Pastena ◽  
A. Esposito ◽  
S. Paiella ◽  
M. Ramera ◽  
...  
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Distal Pancreatectomy ◽  
Frailty Index ◽  
Propensity Score Matching Analysis ◽  
Open Distal Pancreatectomy ◽  
Modified Frailty Index

scholarly journals Modified Frailty Index to Assess Risk in Elderly Patients Undergoing Distal Pancreatectomy: A Retrospective Single-Center Study

2022 ◽  
Author(s):  
Salvatore Paiella ◽  
Matteo De Pastena ◽  
Alessandro Esposito ◽  
Erica Secchettin ◽  
Luca Casetti ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Distal Pancreatectomy ◽  
Frailty Index ◽  
Postoperative Course ◽  
Entire Cohort ◽  
Open Distal Pancreatectomy ◽  
Single Center Study ◽  
Postoperative Confusion ◽  
Modified Frailty Index ◽  
Baseline Characteristics

Abstract Background To compare the postoperative course of elderly patients (≥70 years) submitted to minimally invasive (MIDP) versus open distal pancreatectomy (ODP) and to evaluate if the modified Frailty Index (mFI) predicts the surgical course of elderly patients submitted to DP. Methods Data of patients aged ≥70 who underwent DP at a single institution between March 2011 and December 2019 were retrospectively retrieved. A 2:1 propensity score matching (PSM) was used to correct for differences in baseline characteristics. Then, postoperative complications were compared between the two groups (MIDP vs. ODP). Additionally, the entire cohort of DP elderly patients was stratified according to the mFI into three groups: non-frail (mFI = 0), mildly frail (mFI = 1/2), or severely frail (mFI = 3) and then compared. Results A total of 204 patients were analyzed. After PSM, 40 MIDP and 80 ODP patients were identified. The complications considered stratified homogenously between the two groups, with no statistically significant differences. The severity of the postoperative course increased as mFI did among the three groups regarding any complication (p = 0.022), abdominal collection (p = 0.014), pulmonary complication (p = 0.001), postoperative confusion (p = 0.047), Clavien-Dindo severity ≥3 events (p = 0.036), and length of stay (p = 0.018). Conclusions Elderly patients can be safely submitted to MIDP. The mFI identifies frail elderly patients more prone to develop surgical and non-surgical complications after DP.

scholarly journals Minimally invasive versus open distal pancreatectomy for ductal adenocarcinoma (DIPLOMA): a pan-European propensity score matched study

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S714
Author(s):  
J. van Hilst ◽  
T. de Rooij ◽  
S. Klompmaker ◽  
M. Rawashdeh ◽  
F. Aleotti ◽  
...  
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Distal Pancreatectomy ◽  
Ductal Adenocarcinoma ◽  
Open Distal Pancreatectomy ◽  
Matched Study

scholarly journals Comparison of Minimally Invasive versus Open Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Propensity Score Matching Analysis

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 982 ◽  
Author(s):  
Jaewoo Kwon ◽  
Ki Byung Song ◽  
Seo Young Park ◽  
Dakyum Shin ◽  
Sarang Hong ◽  
...  
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Ductal Adenocarcinoma ◽  
Propensity Score Matching Analysis ◽  
Oncological Outcomes ◽  
Hospital Stays

Background: Few studies have compared perioperative and oncological outcomes between minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD) for pancreatic ductal adenocarcinoma (PDAC). Methods: A retrospective review of patients undergoing MIPD and OPD for PDAC from January 2011 to December 2017 was performed. Perioperative, oncological, and survival outcomes were analyzed before and after propensity score matching (PSM). Results: Data from 1048 patients were evaluated (76 MIPD, 972 OPD). After PSM, 73 patients undergoing MIPD were matched with 219 patients undergoing OPD. Operation times were longer for MIPD than OPD (392 vs. 327 min, p < 0.001). Postoperative hospital stays were shorter for MIPD patients than OPD patients (12.4 vs. 14.2 days, p = 0.040). The rate of overall complications and postoperative pancreatic fistula did not differ between the two groups. Adjuvant treatment rates were higher following MIPD (80.8% vs. 59.8%, p = 0.002). With the exception of perineural invasion, no differences were seen between the two groups in pathological outcomes. The median overall survival and disease-free survival rates did not differ between the groups. Conclusions: MIPD showed shorter postoperative hospital stays and comparable perioperative and oncological outcomes to OPD for selected PDAC patients. Future randomized studies will be required to validate these findings.

scholarly journals Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ke-Min Jin ◽  
Kun Wang ◽  
Quan Bao ◽  
Hong-Wei Wang ◽  
Bao-Cai Xing
Keyword(s):  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Disease Free Survival ◽  
The Elderly ◽  
Multivariate Regression Analysis ◽  
Cancer Specific Survival ◽  
Younger Patients ◽  
Propensity Score Matching Analysis ◽  
American Society

Abstract Background Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients. Methods From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥ 70 years of age) were matched to 128 younger patients (< 70 years of age) to obtain two balanced groups with regard to demographic, therapeutic, and prognostic factors. Results There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score III and comorbidities and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p < 0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175 ml vs. 200 ml, p = 0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p = 0.020), and a higher readmission rate (4.7% vs.0%, p = 0.036). The EG also had longer disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p > 0.05). Old age was not an independent factor for DFS, OS, and CSS by Cox multivariate regression analysis (p > 0.05). Conclusions Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS, and CSS.

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