Pancreatic surgery is safe in elderly patients with PDAC

Area of Science:

• Oncology
• Geriatric Surgery
• Surgical Outcomes

Background:

• Pancreatic ductal adenocarcinoma (PDAC) diagnosis is increasing in the elderly population.
• Elderly PDAC patients often receive suboptimal treatment compared to younger counterparts.
• The safety of surgical intervention for elderly PDAC patients is debated.

Purpose of the Study:

• To evaluate the safety and outcomes of radical resection in elderly versus non-elderly patients with PDAC.
• To compare operation-related factors and postoperative complications between age groups.
• To assess the impact of inflammatory-nutritional status on surgical outcomes in elderly and non-elderly PDAC patients.

Main Methods:

• Retrospective analysis of 892 PDAC patients undergoing radical resection (2012-2021).
• Patients categorized into non-elderly (<70 years) and elderly (≥70 years) groups.
• Comparison of clinicopathological factors, surgical outcomes, and postoperative complications; subgroup analysis of inflammatory-nutritional status.

Main Results:

• Elderly patients presented with earlier AJCC T and N stages but higher ASA grades.
• Elderly patients exhibited poorer inflammatory markers and nutritional status.
• Postoperative complication rates were comparable, except for delayed gastric emptying; poorer inflammatory-nutritional status correlated with more complex procedures, especially in non-elderly patients.

Conclusions:

• Pancreatic surgery is safe for elderly PDAC patients in experienced centers.
• Comprehensive preoperative assessment and meticulous postoperative care are crucial for optimizing outcomes.
• Age alone should not be a contraindication for surgical intervention in PDAC patients.