Elsevier

HPB

Volume 14, Issue 9, September 2012, Pages 583-588
HPB

Original Articles
The safety of a pancreaticoduodenectomy in patients older than 80 years: risk vs. benefits

https://doi.org/10.1111/j.1477-2574.2012.00484.xGet rights and content
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Abstract

Background

A pancreaticoduodenectomy (PD) offers the only chance of a cure for pancreatic cancer and can be performed with low mortality and morbidity. However, little is known about outcomes of a PD in octogenarians.

Methods

Differences in two groups of patients (Group Y, <80 and Group O, ≥80 year-old) who underwent a PD for pancreatic adenocarcinoma were analysed. Study end-points were length of post-operative stay, overall morbidity, 30-day mortality and overall survival.

Results

There were 175 patients in Group Y (mean age 64 years) and 25 patients in Group O (mean age 83 years). Octogenarians had worse Eastern Cooperative Oncology Group (ECOG) Performance Status (PS ≥1: 90% vs. 51%) and American Society of Anesthesiology (ASA) score (>2: 71% vs. 47%). The two groups were similar in underlying co-morbidities, operative time, rates of portal vein resection, intra-operative complications, blood loss, pathological stage and status of resection margins. Octogenarians had a longer post-operative stay (20 vs. 14 days) and higher overall morbidity (68% vs. 44%). There was a single death in each group. At a median follow-up of 13 months median survival appeared similar in the two groups (17 vs. 13 months).

Conclusions

As 30-day mortality and survival are similar to those observed in younger patients, a PD can be offered to carefully selected octogenarians.

Keywords

pancreticoduodenctomy
pancreatic cancer
age
post-operative morbidity
octogenarians
overall survival

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Presented as a poster at the SSO 64th Annual Cancer Symposium (San Antonio, TX, March 2011).