The aim of the study was to determine the impact of age
on curative management and outcomes
of patients with pancreatic ductal adenocarcinoma.
Patients who underwent resection for pancreatic ductal adenocarcinoma at 2 units were retrospectively reviewed (between 2005 and 2017) and stratified by age
(older patients ≥70 years). Regression analysis was used to explore factors impacting administration of adjuvant chemotherapy
. The Kaplan-Meier method was used to estimate overall survival
(time from surgery to death). Statistical significance was set at P
From 2005 to 2014, 222 patients were identified (<70 years, n = 128; ≥70 years, n = 94). Elderly patients were less likely to receive adjuvant chemotherapy
compared with younger patients (odds ratio, 0.57, P
= 0.041). Tumor stage, margin, and year of surgery (post-2011 vs pre-2011) were not predictors for chemotherapy
> 0.05). Frailty was the commonest reason (36.8%) to decline chemotherapy
in elderly patients. In patients receiving adjuvant chemotherapy
, completion rates (P
= 0.32) and overall survival
(24 months vs 30 months, P
= 0.50) were no different.
Elderly patients demonstrate similar outcomes
to younger yet are less likely to commence chemotherapy
because of frailty. Holistic preoperative assessment may improve selection for curative treatment.