Is a surgical approach justified for octogenarians with pancreatic carcinoma? Projecting surgical decision making for octogenarian patients.
BACKGROUND
In recent years, more elderly patients have undergone surgery for pancreatic cancer, although the safety and efficacy of performing complex pancreatic resections in patients older than 80 years remain controversial.


METHODS
Patients with pancreatic cancer who underwent curative surgical treatment were divided into 2 subgroups: the younger group (<80 years) and the octogenarian group (≥80 years).


RESULTS
From March 2005 to December 2013, 194 consecutive surgically curable patients with diagnosed pancreatic cancer were studied, among which 34 (17.5%) were of 80 years or older. There were no significant differences in postoperative severe complication rates for younger and octogenarian groups (16% vs 20%, respectively) or perioperative mortality rates (1.3% vs .0%). The incidence of postoperative delirium in the octogenarian group was greater than that in the younger group (23.5% vs 3.8%).


CONCLUSIONS
Octogenarian pancreatic cancer patients should not be denied a priori the opportunity for surgery, particularly if the patient represents an ideal candidate and if the co-operation of the family can be obtained.
Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi-City, Kochi 781-8555, Japan. Electronic address: tokabaya@gmail.com.
Takehiro
T
Okabayashi
Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi-City, Kochi 781-8555, Japan.
Yasuo
Y
Shima
Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi, Japan.
Jun
J
Iwata
Department of Radiology, Kochi Health Sciences Center, Kochi, Japan.
Sojiro
S
Morita
Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi-City, Kochi 781-8555, Japan.
Tatsuaki
T
Sumiyoshi
Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi-City, Kochi 781-8555, Japan.
Akihito
A
Kozuki
Department of Biostatistics, Kochi Medical School, Kochi, Japan.
Tatsuo
T
Iiyama
Department of Radiology, Kochi Health Sciences Center, Kochi, Japan.
Akihito
A
Nishioka
Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi, Japan.
Manabu
M
Matsumoto
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010180:Pancreatectomy / Q000379:methods / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome
Carcinoma; Octogenarian; Outcome; Pancreas; Surgery