Impact of Patient Age on Postoperative Short-Term and Long-Term Outcome after Pancreatic Resection of Pancreatic Ductal Adenocarcinoma

Abstract

(1) Purpose: to evaluate the impact of age on postoperative short-term and long-term outcomes in patients undergoing curative pancreatic resection for PDAC. (2) Methods: This retrospective single-center study comprised 213 patients who had undergone primary resection of PDAC from January 2000 to December 2018 at the University Hospital of Erlangen, Germany. Patients were stratified according the age into two groups: younger (≤70 years) and older (>70 years) patients. Postoperative outcome and long-term survival were compared between the groups. (3) Results: There were no significant differences regarding inhospital morbidity (58% vs. 67%, p = 0.255) or inhospital mortality (2% vs. 7%, p = 0.073) between the two groups. The median overall survival (OS) and disease-free survival (DFS) were significantly shorter in elderly patients (OS: 29.2 vs. 17.1 months, p < 0.001, respectively; DFS: 14.9 vs. 10.4 months, p = 0.034). Multivariate analysis revealed that age was a significant independent prognostic predictor for OS and DFS (HR 2.23, 95% CI 1.58–3.15; p < 0.001 for OS and HR 1.62, 95% CI 1.17–2.24; p = 0.004 for DFS). (4) Conclusion: patient age significantly influenced overall and disease-free survival in patients with PDAC undergoing primary resection in curative intent.

Impact of Aspirin Intake on Postoperative Survival after Primary Pancreatic Resection of Pancreatic Ductal Adenocarcinoma—A Single-Center Evaluation

“…The corresponding concomitant diseases such as hypertension, cardiovascular and cerebrovascular comorbidities were also more common in our patient cohort with regular aspirin intake. Furthermore, in our cohort patients taking aspirin were found to be older than patients without ASS intake (cASS: 74 years vs. iASS: 70 years vs. no ASS: 67 years, p = 0.039) and age was revealed as independent prognostic survival factor in our analysis and the previous studies [36].…”

Pancreatic adenocarcinoma and aging: understanding the menace for better management

“…Hackner et al [56] Retrospective .004 Xu et al [57] was associated with a longer median survival (17.2 months; 95% confidence interval [CI], 16.1-19.0) compared with those who did not receive adjuvant chemotherapy (12.7 months; 95% CI, 11.8-13.6) in the elderly PDAC patients (80 years or older) and this association was consistent in propensity and subgroup analyses. [58] Besides, further multivariable analysis indicated receipt of adjuvant chemotherapy (hazard ratio [HR], 0.72; 95% CI, 0.65-0.79; P < .001) was associated with a decreased hazard of death in the elderly PDAC patients.…”

“…[55] However, Hackner et al pointed out that the median OS and disease-free survival (DFS) were significantly shorter in elderly PDAC patients receiving surgery, and age was a significant independent prognostic predictor for OS and DFS. [56] Xu et al consistently observed that elderly PDAC patients were associated with worse OS survival after radical resection. [57] All these researches were based on the retrospective and non-randomized study, selection bias and confounding factors inevitably interfered.…”