Pancreaticoduodenectomy can be Performed Safely in Patients Aged 80 years and Older

• Published in: Journal of gastrointestinal surgery Vol. 14; no. 11; pp. 1838 - 1846
• Main Authors: Lee, Minna K., DiNorcia, Joseph, Reavey, Patrick L., Holden, Marc M., Genkinger, Jeanine M., Lee, James A., Schrope, Beth A., Chabot, John A., Allendorf, John D.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01-11-2010; Springer Nature B.V
• Subjects: 2010 SSAT Poster Presentation; Age Factors; Aged; Aged, 80 and over; Carcinoma, Pancreatic Ductal - mortality; Carcinoma, Pancreatic Ductal - surgery; Female; Gastroenterology; Humans; Length of Stay; Male; Medical research; Medicine; Medicine & Public Health; Mortality; Pancreas; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy - adverse effects; Postoperative Complications; Surgery; Survival Analysis; Survival Rate; Elderly patient; Octogenarian; Pancreatic resection; Pancreaticoduodenectomy; Pancreatic ductal adenocarcinoma
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-010-1345-1

Background
Surgery offers the only chance for cure in patients with pancreatic cancer, and a growing number of elderly patients are being offered resection. We examined outcomes after pancreaticoduodenectomy in patients 80 years and older.
Methods
We retrospectively collected data on pancreaticoduodenectomy patients from 1992 to 2009 to compare outcomes between patients older and younger than 80 years. Variables were compared using
t
-, Wilcoxon rank-sum, or Fisher’s exact tests. Survival was compared using Kaplan–Meier analysis and log-rank test.
Results
Patients 80 years and older who underwent pancreaticoduodenectomy were similar with respect to sex, race, blood loss, operative times, reoperation, length of stay, and readmission compared to younger patients. There were no differences in overall complications (47% vs. 51%,
p
 = 0.54), major complications (19% vs. 25%,
p
 = 0.25), and mortality (5% vs. 4%,
p
 = 0.53) when comparing older to younger patients. In a subset who underwent pancreaticoduodenectomy for ductal adenocarcinoma, older patients (
n
 = 45) had a median survival time of 11.6 months compared to 18.1 months in younger patients (
n
 = 346;
p
 < 0.01).
Conclusion
Pancreaticoduodenectomy can be performed safely in select patients 80 years and older. Age alone should not dissuade surgeons from offering patients resection, though elderly patients with pancreatic ductal adenocarcinoma appear to have shorter survival than younger patients with the same disease.