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Reappraisal of the validity of surgery for patients with pancreatic cancer aged 80 years or older stratified by resectability status
Author(s) -
Kondo Naru,
Uemura Kenichiro,
Nakagawa Naoya,
Okada Kenjiro,
Seo Shingo,
Takahashi Shinya,
Murakami Yoshiaki
Publication year - 2020
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.687
Subject(s) - medicine , pancreatic cancer , general surgery , oncology , cancer , gerontology
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.