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

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Melis, M; Marcon, F; Masi, A; Pinna, A; Sarpel, U; Miller, G; Moore, H; Cohen, S; Berman, R; Pachter, HL; Newman, E

Published Date

  • September 2012

Published In

Volume / Issue

  • 14 / 9

Start / End Page

  • 583 - 588

PubMed ID

  • 22882194

Pubmed Central ID

  • 22882194

Electronic International Standard Serial Number (EISSN)

  • 1477-2574

Digital Object Identifier (DOI)

  • 10.1111/j.1477-2574.2012.00484.x

Language

  • eng

Conference Location

  • England