Background: The older population is very heterogeneous with regard to the co-morbidity and the physical reserve. This can result in unacceptably high postoperative complications rates. Th erefore, the aim of the study was to review the literature regarding the outcomes of older patients treated for pancreatic cancer, including the usage of minimal invasive techniques.
Methodology: A review of the literature was carried out including studies on pancreatic cancer in older patients published between 2011 and 2016.
Results: Seventeen retrospective studies were included. The total number of patients was 9981 with the age range of 65 years and more. Studies on surgical treatment alone (1.4%), neoadjuvant/adjuvant treatment with or without surgery (89.4%) and palliative therapy (9.2%) were assessed separately. Appropriate comparison was diffi cult due to the retrospective character and heterogeneity of the study population. Mortality was low, yet there was a great diff erence in morbidity ranging from some percent to even 100% of the study population. Long-term results were poor.
Conclusions: The functional status, not the chronological age alone, is the factor limiting therapeutic options in older patients with pancreatic cancer.
Previous morphological studies of mammalian pancreatic islets have been performed mainly in domestic and laboratory animals. Therefore, the present immunohistochemical investigation was conducted in a wild species, the European bison, using antibodies against glucagon-like peptide-1 (GLP1), glucagon, insulin and somatostatin. Morphological analyses revealed that the mean area of the endocrine pancreas constituted 2.1±0.1% of the whole area of the pancreas, while the mean area of a single pancreatic islet was 13301.5±686.5 µm2. Glucagon-immunoreac- tive cells accounted for 22.4±1.1% and occupied 19.4±0.4% of the average islet area. As many as 14.3±1.4% of pancreatic islet cells were shown to express GLP1, which constituted 12.6±0.8% of the mean area of the islet. Insulin expression was confirmed in 67.6±0.7% of pancreatic islet cells, which represented 62.3±4.9% of the mean total area of the pancreatic islet. As many as 8.5±1.3% of cells stained for somatostatin. The somatostatin-immunoreactive cell area was 4.9±0.3% of the mean pancreatic islet area. In summary, we have determined in detail for the first time the morphometry and islet composition of the European bison pancreas. The distri- bution patterns of immunoreactivities to the substances studied in the European bison show many similarities to those described in other ruminant species.