The survival in octogenarians undergoing surgery for pancreatic cancer and its association with the nutritional status.

Abstract

This study explored the association between the nutritional status and survival outcomes after pancreatic cancer surgery and reconsidered surgical indications in octogenarians. Three hundred and ninety-three consecutive pancreatic cancer patients who underwent resection were analyzed and grouped according to age (< 70years old; septuagenarians [70-79years old], and octogenarians [80-89years old]). The Charlson age comorbidity index and nutritional parameters were recorded. Survival outcomes and their association with nutritional parameters and prognostic factors were examined. The overall survival was worse in the octogenarians than in other patients. The median overall survivals in the < 70years old group, septuagenarians, and octogenarians were 27.2, 26.4, and 15.3months, respectively (P = 0.0828). DUPAN-2 ≥ 150 U/mL, borderline resectable/unresectable tumors, blood loss volume ≥ 500mL, and blood transfusion were predictors of the overall survival among octogenarians. Nutritional parameter values were worse in the octogenarians than in other patients. The octogenarian age group was not an independent predictor of postoperative complications in a univariate analysis. Survival outcomes were poor in octogenarians. However, an age ≥ 80years old alone should not be considered a contraindication for pancreatic cancer surgery. The maintenance of perioperative nutritional status is an important factor associated with the survival.