title: Outcome of pancreaticoduodenectomy in octogenarians: Single institution's experience and review of the literature.
abstract: BACKGROUND
  Pancreatic and perampullary neoplasms in patients aged 80 or older trouble the surgeons because of the risk of surgical treatment. We have reviewed our experience and literature's reports of pancreaticoduodenectomy in octogenarians, evaluating early results and long-term survival in pancreatic cancer group.
  
  
  METHODS
  Three hundred eighty-five patients who underwent pancreaticoduodenectomy for neoplasms from 1998 to 2011 were included in the study, and were divided in two groups: group 1, patients younger than 80 years of age, and group 2, patients 80 years of age and older. Operative morbidity, mortality, disease-free and long-term survival were analysed. English literature was systematically searched for pancreatic resection's outcome in octogenarians.
  
  
  RESULTS
  There were 385 pancreaticoduodenectomies: 362 patients were in group 1 and 23 patients in group 2. There was no significant difference regarding gender, and pathologic findings between the two groups. Complications' rate (40 vs. 43%), mortality rate (4% vs. 0%), and overall median survival for pancreatic cancer patients were not statistically different in the two groups (median 21 vs. 19 months). Literature's review showed 14 reports of pancreatic resection in octogenarians. Most of the studies (particularly in centres with high-volume pancreatic surgery) showed that outcome after pancreatectomy was not different in octogenarians or in younger patients.
  
  
  CONCLUSIONS
  Pancreaticoduodenectomy is an acceptable option for elderly patients. Age alone should not be considered a contraindication to major pancreatic resection, but a careful preoperative evaluation and an accurate postoperative management are mandatory.
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, via Giustiniani 2, 35128 Padua, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Beltrame
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, via Giustiniani 2, 35128 Padua, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Gruppo
authors.affiliation: Department of Oncology, Veneto Institute of Oncology, IOV, via Gattamelata 64, 35128 Padua, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pastorelli
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, via Giustiniani 2, 35128 Padua, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Pedrazzoli
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, via Giustiniani 2, 35128 Padua, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Merigliano
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, via Giustiniani 2, 35128 Padua, Italy. Electronic address: csperti@libero.it.
authors.forename: C
authors.initials: C
authors.lastname: Sperti
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018278:Carcinoma, Neuroendocrine / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Octogenarians; Pancreas; Pancreatectomy; Pancreatic neoplasms; Survival