E290: Frailty and Oncologic Outcomes in Pancreatic Cancer: A Comparative Analysis of Frail and Non-Frail Patients

ePoster Abstract Author(s)

Vicente Ramos, MD

Complex General Surgical Oncology Fellow
Roswell Park Comprehensive Cancer Center
Buffalo, New York, United States

Submitter(s)

Vicente Ramos, MD

Complex General Surgical Oncology Fellow
Roswell Park Comprehensive Cancer Center
Buffalo, New York, United States

Author(s)

Vicente Ramos, MD

Complex General Surgical Oncology Fellow
Roswell Park Comprehensive Cancer Center
Buffalo, New York, United States
Eihab N. Abdelfatah, MD

Clinical Assistant Professor
New York University, Long Island School of Medicine, Department of Surgery
Mineola, New York, United States
KC

Kristin Cianchetti, RN, MSN, CPHQ

Senior Quality Analyst
Roswell Park Comprehensive Cancer Center, Department of Quality and Patient Safety, United States
AG

Anthony George, MS

Biostatistician
Roswell Park Comprehensive Cancer Center, New York, United States
KA

Kristopher Attwood, PhD

Biostatistician
Roswell Park Comprehensive Cancer Center, New York, United States
Gary Mann, MD

Professor of Oncology
Roswell Park Comprehensive Cancer Center, Department of Surgical Oncology
Buffalo, New York, United States
LC

Leonid Cherkassky, MD

Assistant Professor of Oncology
Roswell Park Comprehensive Cancer Center, Department of Surgical Oncology, United States

Introduction: Frailty is a physiological condition known to impact perioperative outcomes, but its influence on long term oncological outcomes remains understudied. This retrospective study assesses perioperative and long-term oncologic outcomes in elderly patients who underwent pancreatic resections.

Methods: We identified patients aged 65 or older who underwent pancreatic resections at Roswell Park Comprehensive Cancer Center between July 2011 and September 2020 using the NSQIP database and Cancer Registry. Frail patients were identified using the revised RAI-A score, with a score of ≥ 38 defining "Frail." Perioperative outcomes were assessed using logistic regression and chi-square analysis, while oncologic outcomes were evaluated via Kaplan-Meier analysis.

Results: A total of 224 patients were analyzed, with a mean age at surgery of 73.8. The median RAI-A score was 37, and 29.9% of patients were classified as frail. There were no significant differences in post-operative complications between frail and non-frail patients (22.8% vs. 22.9%, p=1.0), and the length of hospital stay was similar in both groups (8.9 vs. 8.3 days, p=0.94). While the frail group had a higher discharge rate to a rehabilitation facility (8.9% vs. 4.2%), this difference was not statistically significant (p=0.23). No mortality differences were observed. In a subgroup of 101 patients with pancreatic adenocarcinoma undergoing curative intent resection, frailty is not associated with overall survival, disease-specific survival, or progression-free survival.

Conclusions: In elderly patients undergoing pancreatic surgery, frailty does not correlate with increased postoperative complications, prolonged hospitalization, or higher rates of discharge to rehabilitation facilities. Importantly, frailty does not affect long-term oncologic outcomes, indicating that frail elderly patients derive the same oncologic benefits from surgery as their non-frail counterparts. Providing careful perioperative attention to minimize and address complications is crucial to ensure that frail patients can experience the long-term oncological benefits of surgery.

Learning Objectives:

Understand the impact of frailty on perioperative outcomes in elderly patients undergoing pancreatic surgery, including the assessment of post-operative complications, hospitalization duration, and discharge to rehabilitation.
Evaluate the utilization of the revised RAI-A score as a tool for identifying frail patients and distinguishing them from non-frail patients undergoing pancreatic surgical resection.
Assess the influence of frailty on long-term oncologic outcomes in elderly patients with pancreatic adenocarcinoma who undergo curative intent resection, including overall survival, disease-specific survival, and progression-free survival.