title: Pancreatic resection in the octogenarian: a safe option for pancreatic malignancy.
abstract: BACKGROUND
  The incidence of pancreatic cancer is age related; patients older than the age of 65 represent 60% of all cases. We assessed our institution's experience and outcomes with pancreatic resection for malignancy in patients in their ninth decade.
  
  
  METHODS
  We reviewed records of patients undergoing pancreatic resection for malignancy at our institution between 1990 and 2007. Demographics, laboratory, treatment, and outcomes data were gathered. Comparisons were made between patients older and younger than the age of 80. Survival was analyzed using the Kaplan-Meier method and comparisons between groups were performed using the log-rank test. Regression methods were used to evaluate predictors of outcomes.
  
  
  RESULTS
  There were 517 pancreatic resections for cancer reviewed. Of these, 27 patients were 80 years or older (age range 80 to 91 years), compared with 490 patients less than 80 (range 20 to 79 years). The distribution of clinical characteristics was similar between the 2 groups. The majority of patients undergoing pancreatic resection harbored a mass in the head of the pancreas, so the most common procedure was pancreaticoduodenectomy (n = 398, 78%). There were no significant differences in complication rates for younger and older groups (59% vs 52%, respectively, p = 0.4), median length of stay (11 vs 12 days, p = 0.33), or perioperative mortality rates (3.7% vs 3.7%, p = 1.0). Overall survival between the 2 groups was similar (21.9 vs 33.3 months, p = 0.18).
  
  
  CONCLUSIONS
  Pancreatectomy for malignancy is a safe option for the elderly. Patients older than age 80 achieved similar results, with similar rates of perioperative complications and mortality. Pancreatectomy for cancer offers a similar survival benefit in both groups.
authors.affiliation: Department of Surgery, The Ohio State University, Columbus, OH, USA.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Hatzaras
authors.forename: Carl
authors.initials: C
authors.lastname: Schmidt
authors.forename: Dori
authors.initials: D
authors.lastname: Klemanski
authors.forename: Peter
authors.initials: P
authors.lastname: Muscarella
authors.forename: W Scott
authors.initials: WS
authors.lastname: Melvin
authors.forename: E Christopher
authors.initials: EC
authors.lastname: Ellison
authors.forename: Mark
authors.initials: M
authors.lastname: Bloomston
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult