title: Eligibility Criteria Specific to Pancreaticoduodenectomy for Octogenarians: Single-center Opinion.
abstract: Pancreaticoduodenectomy (PD) treatment outcomes in elderly patients have been reported to be acceptable, but the eligibility criteria are not clear. To elucidate the importance of PD in octogenarians in particular, we set five eligibility criteria for elderly patients based on preoperative cardiac and pulmonary function, nutritional status, daily activity status, and psychological independence status for the first time and evaluated prospectively whether the validity of patient selection was adaptable.
  
  
  
  The study population consisted of 222 patients with pancreaticobiliary cancer aged over 70 years. The patients were divided into two groups: 192 patients as septuagenarians and 30 as octogenarians. Postoperative morbidity and long-term outcome were compared between the two groups, and prognostic factors relating to survival time were identified.
  
  
  
  Octogenarians had a significantly higher frequency of two or more comorbidities (p<0.0001). The difference in the mortality rates between the two groups was not significant, being 3.3% and 4.2%, respectively. No difference between the two groups was found in overall survival rate, including deaths due to other diseases, for any type of pancreaticobiliary cancer. Independent prognostic factors relating to survival duration were intraoperative blood loss (p=0.0004) and duration of surgery (p=0.0093).
  
  
  
  These five eligibility criteria for PD in elderly patients are also satisfactorily applicable to octogenarian patients. These criteria may be helpful when uncertainties arise regarding the selection of PD.
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan tansiosu@twmu.ac.jp.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Takebumi
authors.initials: T
authors.lastname: Usui
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kuhara
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuchiya
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Tatsuomi
authors.initials: T
authors.lastname: Miyauchi
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Kono
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Shimojima
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Asaka
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamaguchi
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Yokomizo
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimakawa
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshimatsu
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Katsube
authors.affiliation: Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Naritaka
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000401:mortality*; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: Pancreaticoduodenectomy; octogenarian; pancreaticobiliary cancer