Is 80 too old for pancreatic cancer surgery?

Is 80 too old for pancreatic cancer surgery?

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How old is too old to go under the knife for pancreatic cancer? Photo: Getty Images

How old is too old to go under the knife for pancreatic cancer? Photo: Getty Images

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SURGEONS should not deny surgery to pancreatic cancer patients aged over 80 as they face no more complications than younger patients.

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SURGEONS should not deny surgery to pancreatic cancer patients aged over 80 as they face no more complications than younger patients.

In a paper published in the ANZ Journal of Surgery, co-author Associate Professor Mehrdad Nikfarjam compared the pancreatic cancer surgery outcomes of 17 patients aged over 80 to 148 younger patients.

Overall, patients aged over 80 had similar complication rates to younger patients and a similar length of hospital stay.

"No difference in complications were seen in these patients," he said. "Age itself should not be used as the basis of determining suitability for surgery."

He has suggested some surgeons may need to reassess their attitude to treating older patients.

"In Australia in particular, there is anecdotal evidence that some have used an age as a cut-off for determining suitability for pancreatic operations," Associate Professor Nikfarjam said.

"The elderly should not be denied best possible treatments based on their age."

He said fragility is a much more important predictor of complications and mortality in patients undergoing pancreatic surgery than age alone.

"The take-home message from this Australia first report is that surgeons should judge suitability for pancreatic surgery on a patient's frailty rather than age," he said.

Pancreatic cancer tumour surgery often entails a pancreaticoduodenectomy, where the head of the pancreas, portions of intestine and bile duct are removed and reconstructed to restore continuity.

The six-to-eight hour operation can be complex. It has a 1-2 per cent mortality rate and 40-50 per cent chance of complications.

Associate Professor Nikfarjam is an Austin Health liver and pancreatic surgeon who works with the University of Melbourne's Department of Surgery. He also founded not-for-profit pancreatic cancer organisation Pancare.

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