Surgery today · 2026
Postoperative outcomes of pancreatoduodenectomy for pancreatic head malignancy in patients over 85 years of age: A safety evaluation using propensity score matching.
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Yoshiya Shohei, Yamashita Yo-Ichi, Inomata Naotaka, Kawada Ippei, Nakamura Sota, Tada Kazuhiro, Kuroda Yosuke, Iwaki Kentaro, Fukuzawa Kengo, Yoshizumi Tomoharu
Аннотация
INTRODUCTION: As the global population ages, older patients undergo pancreatoduodenectomy (PD). This study aimed to evaluate the safety and postoperative outcomes of PD in patients > 85 years of age.
METHODS: We reviewed 200 consecutive PDs and compared the postoperative outcomes in patients aged ≥ 85 years using propensity score matching (PSM).
RESULTS: After PSM, no differences in the clinical characteristics were observed between the two cohorts (n = 16 each). Those aged ≥ 85 years had a significantly lower induction rate of adjuvant chemotherapy (p < 0.0001) and a higher rate of best supportive care selection at recurrence (BSC) (p = 0.033) than those aged < 85 years. There was no significant difference in the rate of non-cancer-related deaths (p = 0.18). Although there were no significant differences in the -free survival rates (p = 0.89), the overall survival rate of those ≥ 85 years was significantly worse (p = 0.023). The risk factors for death after surgery were tumor-related factors and BSC (p = 0.0012). An age ≥ 85 years was not a risk factor for major postoperative complications or death after surgery.
CONCLUSIONS: PD can be safely performed in patients aged ≥ 85 years without increasing postoperative complications and recurrences in the cases with appropriate patient selection.
METHODS: We reviewed 200 consecutive PDs and compared the postoperative outcomes in patients aged ≥ 85 years using propensity score matching (PSM).
RESULTS: After PSM, no differences in the clinical characteristics were observed between the two cohorts (n = 16 each). Those aged ≥ 85 years had a significantly lower induction rate of adjuvant chemotherapy (p < 0.0001) and a higher rate of best supportive care selection at recurrence (BSC) (p = 0.033) than those aged < 85 years. There was no significant difference in the rate of non-cancer-related deaths (p = 0.18). Although there were no significant differences in the -free survival rates (p = 0.89), the overall survival rate of those ≥ 85 years was significantly worse (p = 0.023). The risk factors for death after surgery were tumor-related factors and BSC (p = 0.0012). An age ≥ 85 years was not a risk factor for major postoperative complications or death after surgery.
CONCLUSIONS: PD can be safely performed in patients aged ≥ 85 years without increasing postoperative complications and recurrences in the cases with appropriate patient selection.