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Comparative Study
. 2013 Jan;15(1):24-30.
doi: 10.1111/j.1477-2574.2012.00549.x. Epub 2012 Aug 26.

Results of pancreatic surgery in the elderly: is age a barrier?

Melissa Oliveira-Cunha  1 , Deep J Malde, Amer Aldouri, Gareth Morris-Stiff, Krishna V Menon, Andrew Malvern Smith
Affiliations
Comparative Study

Results of pancreatic surgery in the elderly: is age a barrier?

Melissa Oliveira-Cunha et al. HPB (Oxford). 2013 Jan.

Abstract

Background: By 2033, the number of people aged 85 years and over in the UK is projected to double, accounting for 5% of the total population. It is important to understand the surgical outcome after a pancreatic resection in the elderly to assist decision making.

Methods: Over a 9-year period (from January 2000 to August 2009), 428 consecutive patients who underwent a pancreatic resection were reviewed. Data were collected on mortality, complications, length of stay and survival. Patients were divided into two groups (younger than 70 and older than 70 years old) and outcomes were analysed.

Results: In all, 119 (27.8%) patients were ≥ 70 years and 309 (72.2%) patients were < 70 years. The median length of stay for the older and younger group was 15 days (range 3-91) and 14 days (range 3-144), respectively. The overall mortality was 3.4% in the older group and 2.6% in the younger group (P = 0.75). The older cohort had a cumulative median survival of 57.3 months (range 0-119), compared with 78.7 months (range 0-126) in the younger cohort (P < 0.0001). In patients undergoing a pancreatic resection for ductal adenocarcinoma and cholangiocarcinoma there was a significant difference in survival with P-values of 0.043 and 0.003, respectively. For ampullary adenocarcinoma, the older group had a median survival of 47.1 months compared with 68.3 months (P = 0.194).

Conclusion: Results from this study suggest that while elderly patients can safely undergo a pancreatic resection and that age alone should not preclude a pancreatic resection, there is still significant morbidity and mortality in the octogenarian subgroup with poor long-term survival with the need for quality-of-life assessment.

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Figures

Figure 1
Figure 1
Survival curve comparing all patients 70 years of age and older undergoing a pancreatic resection compared with patients younger than 70 years old
Figure 2
Figure 2
Survival curve comparing all patients divided into four groups, younger than 60 years old, 60 to 69 years old, 70 to 79 years old and older than 80 years old that underwent a pancreatic resection for ductal adenocarcinoma, Cholangiocarcinoma and ampullary adenocarcinoma
Figure 3
Figure 3
Survival curves comparing all patients 70 years of age and older undergoing a pancreatic resection for ductal adenocarcinoma compared wuth patients younger than 70 years old
See this image and copyright information in PMC

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