Elderly Patients Strongly Benefit from Centralization of Pancreatic Cancer Surgery: A Population-Based Study

Annals of Surgical Oncology
Lydia G M van der GeestValery E P P Lemmens

Abstract

Series from expert centers suggest that pancreas cancer surgery is safe for elderly patients but nationwide data, taking hospital volume into account, are lacking. From the Netherlands Cancer Registry, all 3420 patients who underwent pancreatoduodenectomy (PD) for primary pancreatic or periampullary carcinoma in 2005-2013 were selected. Associations between age (<75, ≥75 years), hospital volume (tertiles), and postoperative mortality (30, 90 day) were evaluated by χ (2) tests and logistic regression analyses. Overall survival was investigated by means of Kaplan-Meier and Cox proportional hazard regression analyses. The proportion of elderly patients (≥75 years) undergoing PD increased from 15 % in 2005-2007 to 20 % in 2011-2013 (p = 0.009). In low (<15 per year), medium (15-28 per year), and high (>28 per year) hospital volume tertiles, the proportion of elderly patients was 16, 20, and 17 %, respectively (p = 0.10). With increasing hospital volume, 30-day postoperative mortality was 6.0-4.5-2.9 % (p = 0.002) and 90-day mortality 9.3-8.0-5.3 % (p = 0.001), respectively. Within each volume tertile, adjusted 30- and 90-day mortality of elderly patients was 1.6-2.5 times higher compared to outcomes of younger patients. Adjusted 30...Continue Reading

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Citations

May 16, 2017·Journal of Surgical Oncology·Linde A D BusweilerJohanna W van Sandick
May 4, 2018·Journal of Epidemiology and Community Health·Reea AholaJohanna Laukkarinen
May 1, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Adam PolonskiFaik G Uzunoglu
Oct 28, 2017·Surgery Today·Takefumi KitazawaTomonori Hasegawa
Aug 29, 2018·Canadian Journal of Gastroenterology & Hepatology·Anna C M GeraedtsMechteld C de Jong
May 11, 2020·Annals of Surgical Oncology·Jesse V GroenUNKNOWN Dutch Pancreatic Cancer Group
Sep 21, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Minas BaltatzisNicola De Liguori Carino
Dec 18, 2019·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Jin-Ming WuYu-Wen Tien

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