Duodenopancreatectomy for pancreatobiliary malignancies in elderly patients

stereotactic radiotherapy in selected cases. In some instances, hepatic metastases were treated with radiofrequency. Survival was calculated using the Kaplan-Meier method, and the survival curves were compared with the log-rank test. Significance was set at P <0.05. Results: Recurrence (liver) 5 years after surgery developed in only 1 patient. Thirty-seven patients underwent reoperation: the indication for surgery was recurrence in 31 patients (radical resection in 13, palliative resection in 7, bypass in 11) and a second cancer in 6. Furthermore, 130 patients underwent chemotherapy and/or radiotherapy, and 23 only supportive therapy. The mean and median overall survival time was 10 and 6 months, respectively. Survival was significantly longer in patients undergoing surgery (median, 17 months) or chemoradiation (median, 6 months) than in those who received supportive therapy (median, 3.5 months) (P1⁄40.01). Survival was longer in patients treated with surgery than in those who underwent chemotherapy (P1⁄40.02). Among those who received chemotherapy and/or radiotherapy, 7 complete and 2 partial radiologic responses were observed: 8 patients are alive (median survival, 18 months, range, 12-48), and 1 patient died 25 months after tumor recurrence. Stabilization of disease was observed in the other 17 patients (median, 12 months; range, 3-36). Conclusions: Although the prognosis of patients with recurrent pancreatic cancer continues to be poor, multimodality management of recurrence may offer good palliation in selected patients.