The Short- and Long-Term Outcomes of Pancreatic Resection for Pancreatic Adenocarcinoma in Patients Older Than 75 Years

Abstract

The short-and long-term outcomes of pancreatic resection for pancreatic adenocarcinoma have not been fully evaluated in elderly patients. This retrospective study selected patients who underwent curative surgery for pancreatic cancer at our institution. Patients were categorized into 2 groups: nonelderly patients (age , 75 years; group A) and elderly patients (age 75 years; group B). The surgical morbidity, surgical mortality, overall survival (OS), and recurrence-free survival (RFS) rates in the 2 groups were compared. A total of 221 patients were evaluated in the study. The overall complication rates were 44.8% in group A and 52.6% in group B. Surgical mortality was observed in 2 patients due to an abdominal abscess and cardiovascular disease in group A (1.1%) and in 1 patient due to postoperative bleeding in group B (2.6%). There were no significant differences (P ¼ 0.379 and P ¼ 0.456, respectively). Furthermore, the 5-year OS and RFS rates were similar between the elderly patients and nonelderly patients (18.55 versus 20.2%, P ¼ 0.946 and 13.1% versus 16.0%, P ¼ 0.829, respectively). The short-term outcomes and long-term survival after pancreatic resection for pancreatic adenocarcinoma were almost equal in the elderly and the nonelderly patients in this study. Therefore, it is unnecessary to avoid pancreatic resection for pancreatic adenocarcinoma in elderly patients simply because of their age.Key words: Pancreatic cancer -Elderly patient -Pancreatic resection P ancreatic cancer is one of the most lethal human cancers. It is the fifth-most common cancer and the fourth leading cause of cancer-related mortality worldwide, with a 5-year survival rate of less than 5% in all stages.1,2 Complete resection is essential for obtaining a cure in patients with pancreatic cancer. However, the morbidity after pancreatic resection has been reported to range from 30% to 65%, and the complications are sometimes fatal. [3][4][5][6][7] The number of elderly patients is rapidly growing worldwide. With people aged 75 and older representing the fastest growing subset of the population, the management of complex surgical issues promises to become even more challenging. However, previous studies excluded patients over the age of 75. Furthermore, few authors have evaluated the short-and long-term outcomes of pancreatic resection for pancreatic adenocarcinoma in patients aged 75 years and older. [8][9][10][11] Therefore, the short-term outcomes and long-term survival of pancreatic resection for pancreatic adenocarcinoma in elderly patients are still unclear. In addition, generally, elderly patients often have comorbidities and age-related physiologic problems that can lead to greater postoperative complications or poor survival than in nonelderly patients.We retrospectively investigated the short-term outcomes and long-term survival after pancreatic resection for pancreatic adenocarcinoma in patients older than 75 years and compared them with nonelderly patients. Patients and Methods PatientsThe study subjects were selected from t...

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

“…In 2012, a meta-analysis reported that elderly patients experience higher rates of postoperative complications and mortality [6]. Other manuscripts, afterward, found that pancreatic surgery has similar safety and efficacy profiles in elderly versus non-elderly [7][8][9][10]. Regarding minimally invasive pancreaticoduodenectomy, data analysis on 1768 elderly patients submitted to laparoscopic versus open pancreaticoduodenectomy from the United States National Cancer Dabatase showed that minimally invasive cases experience lower mortality rates [11].…”