Outcomes of Pancreatic Surgery in the Elderly Patients with Pancreatic Adenocarcinoma: Case Series Analysis

Due to the complexity and low survival rate of pancreatic resection, it is difficult to decide for resection for elderly patients with pancreatic ductal adenocarcinoma (PDAC). In this retrospective study, we aimed to compare the morbidity, mortality, and long-term survival results of 122 elderly patients (≥ 70 years) and 52 young patients (< 70 years) diagnosed with pancreatic resection due to PDAC. The tumor size and albumin levels were higher in the younger patient group (p = 0.035 and p = 0.002, respectively). The Elderly group had a higher frequency of comorbid and multiple comorbid diseases (p < 0.005 and p ≤ 0.024, respectively). The adjuvant radiotherapy and chemotherapy completion rates were higher in the younger patient group (p = 0.028 and p = 0.021, respectively). The overall survival time of younger patients was significantly higher than elderly patients (p = 0.043). However, the difference between the two groups in terms of disease-free survival was not significant (p = 0.187). The univariate analysis results for disease-free survival and overall survival revealed that age ≥ 70 years, presence of postoperative complications, reoperation, readmission, failure to complete adjuvant chemotherapy, surgical margin positivity, lymph node, and advanced tumor stage were statistically significant risk factors. Although surgical mortality and complication rates are higher in elderly patients, these rates can be reduced to acceptable levels in high-volume centers, thus ensuring that pancreatic surgery can be performed safely.