Impact of Physiological Reserve on Overall Survival in Middle-Old (75–84 Years) Patients Undergoing Pancreaticoduodenectomy: A Single-Center Retrospective Analysis

With increasing life expectancy, the number of elderly patients undergoing pancreaticoduodenectomy (PD) due to pancreatic cancer is increasing. However, physiological markers affecting overall survival (OS) in this age group have not been clearly defined. This study aims to evaluate the factors affecting OS in middle-old patients aged 75–84 years who underwent PD. In this retrospective study, middle-old patients who underwent PD were examined and divided into two groups according to OS status. Performance status, nutritional status, and frailty level were assessed with clinical and laboratory-based scales. A total of 34 patients were included (median age, 77.5 years [76–79.2]; 58.8% male). ECOG 2 was significantly higher in the non-survivor group (62.5% vs. 22.2%; p=0.017). GNRI ≥98 was observed more frequently in the survival group (72.2% vs. 31.3%; p=0.017). FI-Lab ≥0.25 was higher in the non-survival group (56.3% vs. 11.1%; p=0.005). Adjuvant chemotherapy treatment was higher in the survival group (88.9% vs. 43.8%; p=0.005). In Kaplan–Meier analysis, median survival was significantly longer in patients with GNRI ≥98, ECOG 1, and FI-Lab