Validating biologic age in selecting elderly patients with pancreatic cancer for surgical resection

Anthony J. Scholer, Rebecca Marcus, Mary Garland-Kledzik, Shu Chin Chang, Adam Khader, Juan Santamaria-Barria, Zeljka Jutric, Ronald Wolf, Melanie Goldfarb

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background and Objectives: Selecting frail elderly patients with pancreatic cancer (PC) for pancreas resection using biologic age has not been elucidated. This study determined the feasibility of the deficit accumulation frailty index (DAFI) in identifying such patients and its association with surgical outcomes. Methods: The DAFI, which assesses frailty based on biologic age, was used to identify frail patients using clinical and health-related quality-of-life data. The characteristics of frail and nonfrail patients were compared. Results: Of 242 patients (median age, 75.5 years), 61.2% were frail and 32.6% had undergone pancreas resection (surgery group). Median overall survival (mOS) decreased in frail patients (7.13 months, 95% confidence interval [CI]: 5.65–10.1) compared with nonfrail patients (16.1 months, 95% CI: 11.47–34.40, p = 0.001). In the surgery group, mOS improved in the nonfrail patients (49.4%; 49.2 months, 95% CI: 29.3–79.9) compared with frail patients (50.6%, 22.1 months, 95% CI: 18.3–52.4, p = 0.10). In the no-surgery group, mOS was better in nonfrail patients (54%; 10.81 months, CI 7.85–16.03) compared with frail patients (66%; 5.45 months, 95% CI: 4.34–7.03, p = 0.02). Conclusions: The DAFI identified elderly patients with PC at risk of poor outcomes and can identify patients who can tolerate more aggressive treatments.

Original languageEnglish (US)
Pages (from-to)394-404
Number of pages11
JournalJournal of Surgical Oncology
Volume127
Issue number3
DOIs
StatePublished - Mar 2023

Keywords

  • deficit accumulation frailty index
  • distal pancreatectomy
  • pancreas resection
  • whipple

ASJC Scopus subject areas

  • Surgery
  • Oncology

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