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Comparative Study
. 2024 Jul 4;36(1):141.
doi: 10.1007/s40520-024-02804-9.

Pancreaticoduodenectomy in patients < 75 years versus ≥ 75 years old: a comparative study

Muhammer Ergenç  1 , Tevfik Kıvılcım Uprak  2 , Ayşegül Bahar Özocak  3 , Şakir Karpuz  2 , Mümin Coşkun  2 , Cumhur Yeğen  2 , Ali Emre Atıcı  2
Affiliations
Comparative Study

Pancreaticoduodenectomy in patients < 75 years versus ≥ 75 years old: a comparative study

Muhammer Ergenç et al. Aging Clin Exp Res. .

Abstract

Objective: This study aimed to compare the postoperative outcomes of < 75-year-old patients and ≥ 75-year-old patients who underwent pancreaticoduodenectomy (PD) for pancreatic head and periampullary region tumors.

Methods: Patients who underwent PD in our hospital between February 2019 and December 2023 were evaluated. Demographics, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores, American Society of Anesthesiologists (ASA) scores, comorbidities, hospital stays, complications, and clinicopathological features were analyzed. Patients were divided into < 75 years (Group A) and ≥ 75 years (Group B) groups and compared.

Results: The median age of the entire cohort (n = 155) was 66 years (IQR = 16). There was a significant difference between Group A (n = 128) and Group B (n = 27) regarding the ECOG-PS and ASA scores. There was no significant difference between the groups regarding postoperative complications. The 30-day mortality rate was greater in Group B (p = 0.017). Group B had a cumulative median survival of 10 months, whereas Group A had a median survival of 28 months, with a statistically significant difference (p < 0.001). When age groups were stratified according to ECOG-PS, for ECOG-PS 2-3 Group A, survival was 15 months; for ECOG-PS 2-3 Group B, survival was eight months, and the difference was not statistically significant (p = 0.628).

Conclusions: With the increasing aging population, patient selection for PD should not be based solely on age. This study demonstrated that PD is safe for patients older than 75 years. In older patients, performance status and the optimization of comorbidities should be considered when deciding on a candidate's suitability for surgery.

Keywords: Elderly; Geriatric surgery; Pancreatectomy; Pancreatic adenocarcinoma; Performance status; Survival.

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Conflict of interest statement

The authors have no relevant financial or nonfinancial interests to disclose.

Figures

Fig. 1
Fig. 1
Survival curve (panel A) comparing < 75 years versus ≥ 75 years old patients and survival curve (panel B) comparing patients according to Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores
Fig. 2
Fig. 2
Survival curve comparing < 75 years versus ≥ 75 years old patients stratified according to ECOG-PS 0–1 (panel A) and ECOG-PS 2–3 (panel B)
See this image and copyright information in PMC

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