Outcomes of pancreatic malignancy in octogenarians: A single tertiary center experience

e24008 Background: Pancreatic adenocarcinoma (PC) is generally diagnosed at a late stage, with a dismal prognosis. Patients aged 75-84 years constitute 28% of all patients. Surgery is the only way to cure, however, some surgeons have been hesitant to offer surgery to patients with advanced age due to lack of evidence available about the effectiveness and safety of treatments for this age group. Deficits accumulation frailty indices (FI) utilize readily available clinical data and easily obtained patient-reported information to predict hospitalization and mortality of older individuals. The goal of this large sample study is to profile octogenarians with PC. Methods: From 2015-2017, 440 patients over the age of 70 with biopsy confirmed PC were retrospectively reviewed. Among those, the outcomes of 129 (29.3%) pts older than 80 years of age were evaluated including patient’s characteristics, local control, systemic therapy, comprehensive geriatric assessment domains, specific geriatric outcomes and survival duration. Results: Median patients' age was 83 years (range 83-91) and 61(47.4%) were female. Patients with ECOG 0-1 at diagnosis were 109 pts (84.4%). Based on the FI, 28 patients (21.7%) were fit, while 79 (61.2%) were prefrail and 22 patients (17.1%) were frail. 33 patients (25.5%) presented as stage IV disease and 96(74.5%) as locally advanced PC. 46 patients (35.6%) had elective surgical resection. 53 patients (41.1%) received chemotherapy, 14 (10.8%) neoadjuvant, 17(20.9%) adjuvant and 12 (17.1%) palliative therapy. Among patients who had surgery, 10 (21.7%) had grade ≥3 adverse events and 6 (13%) had unplanned hospitalization. Median overall survival of resectable patients was 25.3 months. There was no statistically significant difference in survival after surgery in patients older than 80 years of age compared to younger than 80. Results of the multiple linear regression indicated that there was a moderate collective significant effect between the frailty index, ECOG, surgery, WT loss, albumin level, Cr clearance, Hb, and survival, (F(3,120) = 22, p < .001, R = 0.35, R = 0.34). Frailty index (p = .027), ECOG (p < .001) and surgery (p = .009) were significant individual predictors of the outcomes. Conclusions: Among older adult, Fit octogenarians experienced similar rate of mortality as patients younger than 80years old after elective pancreatic cancer surgery. Specific factors may also affect the outcome of surgery for older adults with cancer. These should be considered when assessing patients’ health and selecting them for surgery. A thorough preoperative evaluation can help ensure a better postoperative outcome.