title: Pancreatectomy for adenocarcinoma in elderly patients: postoperative outcomes and long term results: a study of the French Surgical Association.
abstract: OBJECTIVE
  To determine the benefit of surgery for resectable pancreatic adenocarcinomas (PAs) in elderly patients.
  
  
  METHODS
  From 2004 to 2009, 932 patients with resectable PAs underwent pancreatectomies without neoadjuvant treatment in 37 institutions. The patients were divided into three groups according to age: <70 years (control group; n = 580); 70-79 years (70s group, n = 288), and ≥ 80 years (80s group; n = 64). Preoperative, intraoperative, postoperative, and histological data were recorded to assess the postoperative course and survival.
  
  
  RESULTS
  Preoperative or intraoperative characteristics, and the histological findings were comparable in the three groups. Postoperative mortality and morbidity rates did not differ in the three groups. Adjuvant therapies were more frequently used in younger patients than in elderly patients (p < 0.01). The overall 1-year, 3-year, and 5-year survival rates of control group/70's group/80's group were 82.2%/75.7%/75.7%, 49.9%/41.8%/31%, and 38.7%/33.2%/0%, respectively (p = 0.16). The median survival of the control, 70s, and 80s groups was 24 months, 35.3 months, and 30 months, respectively. Four independent prognostic indicators were identified by multivariate analysis: venous invasion (hazard ratio (HR) = 2.12), arterial invasion (HR = 2.96), positive lymph nodes (HR = 2.25), and adjuvant treatment (HR = 0.65).
  
  
  CONCLUSIONS
  Fit elderly patients with resectable PAs should not be excluded from surgical resection of PA solely because of their real age. Moreover, elderly patients seem to obtain similar advantages from pancreatectomies than younger patients.
authors.affiliation: Department of Surgical Oncology, Institut Paoli Calmettes, 232 Bd Sainte Marguerite, 13009 Marseille, France. turrinio@ipc.unicancer.fr
authors.forename: O
authors.initials: O
authors.lastname: Turrini
authors.forename: F
authors.initials: F
authors.lastname: Paye
authors.forename: P
authors.initials: P
authors.lastname: Bachellier
authors.forename: A
authors.initials: A
authors.lastname: Sauvanet
authors.forename: A
authors.initials: A
authors.lastname: Sa Cunha
authors.forename: Y P
authors.initials: YP
authors.lastname: Le Treut
authors.forename: M
authors.initials: M
authors.lastname: Adham
authors.forename: J Y
authors.initials: JY
authors.lastname: Mabrut
authors.forename: L
authors.initials: L
authors.lastname: Chiche
authors.forename: J R
authors.initials: JR
authors.lastname: Delpero
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract; D017024:Chemotherapy, Adjuvant; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018579:Patient Selection; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome