Reappraisal of the validity of surgery for patients with pancreatic cancer aged 80 years or older stratified by resectability status

Purpose The aim of this study was to assess the validity of surgical resection for patients with pancreatic ductal adenocarcinoma (PDAC) aged ≥80 years stratified by resectability status. Methods Medical records of 245 patients with resectable (R) and 169 with borderline resectable/unresectable (BR/UR) PDAC were reviewed retrospectively. Of the total of 414 patients, 56 (14%) were ≥80 years. The prognostic impact of age ≥80 years was analyzed with stratification by resectability status. Results No significant difference was found in the incidence of major complications between patients aged ≥80 versus <80 years (12% vs. 16% respectively; P  = 0.53). However, patients aged ≥80 years were significantly less likely to receive adjuvant gemcitabine + S‐1 chemotherapy than those <80 years (39% vs. 83%, respectively; P  < 0.001). Multivariate analyses identified age ≥80 years as an independent risk factor for poor survival in the BR/UR group ( P  = 0.01), whereas it did not affect survival in the R group. Conclusion Patients aged ≥80 years had a similar prognosis to <80 years in R PDAC, whereas they had significantly worse prognosis in BR/UR PDAC. These findings suggest that surgical resection for patients with PDAC aged ≥80 years is validated in R PDAC, whereas its survival benefit might be limited in BR/UR PDAC.