Octogenarians with lower BMI have comparatively poor survival in potentially resectable pancreatic cancer: outcomes over 5-year follow-up

Abstract

Background

The indication and benefit of pancreatectomy for octogenarians with pancreatic cancer remains controversial. This study aims to evaluate prognostic factors in patients with pancreatic cancer after 5-year follow-up.

Methods

We retrospectively reviewed the 229 patients who underwent pancreatectomy at our hospital between 2005 and 2018 for potentially resectable pancreatic cancer. Of these, 216 patients were divided into three groups based on age: <70 years old (n = 97), 70–79 years old (n = 81), and ≥80 years old (n = 38).

Results

Seventy patients (32.4 %) achieved 5-year survival. Median survival time and five-year overall survival in each group were: 37.3 months and 37.1 % for patients <70 years old, 26.0 months and 30.9 % for those 70–79 years old, and 20.2 months and 23.7 % for those ≥80 years old. The patients who were ≥80 years old and had BMI <20 kg/m² had a significantly poorer prognosis than those <80 years old and who had BMI ≥20 kg/m² (P = 0.006). Independent prognostic factors were age ≥80 years and BMI <20 kg/m², preoperative CA19-9 ≥ 500 IU/L, transfusion, tumor size ≥20 mm, positive lymph node, and non-completion of adjuvant therapy. Moreover, age ≥80 years, BMI <20 kg/m², preoperative CA19-9, and severe complications were each associated with non-completion of adjuvant therapy.

Conclusions

Octogenarians with lower BMI, which might be attributed to lower completion rate of adjuvant therapy, had especially poorer prognosis.