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
References
Oct 1, 1995·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·G A van der SandenF E van Leeuwen
Apr 12, 2002·The New England Journal of Medicine·John D BirkmeyerDavid E Wennberg
Jul 31, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·William L ReadJay F Piccirillo
Dec 6, 2005·Annals of Surgery·N Tjarda van HeekDirk J Gouma
Jun 21, 2007·Cancer·Karl Y BilimoriaMark S Talamonti
Sep 2, 2008·Annual Review of Medicine·John D Birkmeyer, Justin B Dimick
Sep 2, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Karyn B StitzenbergNeal J Meropol
Aug 17, 2010·Langenbeck's Archives of Surgery·Mirja SargentChristiane J Bruns
Sep 9, 2010·JAMA : the Journal of the American Medical Association·John P NeoptolemosUNKNOWN European Study Group for Pancreatic Cancer
Oct 28, 2010·British Journal of Cancer·W J LouwmanM L G Janssen-Heijnen
Apr 2, 2011·Journal of the American Geriatrics Society·Taylor S RiallJames S Goodwin
Apr 19, 2011·The British Journal of Surgery·G A GooikerUNKNOWN Signalling Committee Cancer of the Dutch Cancer Society
May 6, 2011·Annals of Surgical Oncology·Gea A GooikerBert A Bonsing
Jul 1, 2011·The British Journal of Surgery·V E P P LemmensI H J T de Hingh
Nov 8, 2011·Journal of the American College of Surgeons·Skye C MayoTimothy M Pawlik
Dec 29, 2011·Oncology Nursing Forum·Joseph D TarimanKaren G Schepp
Jan 13, 2012·The British Journal of Surgery·R F de WildeUNKNOWN Dutch Pancreatic Cancer Group
Sep 8, 2012·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Prashant SukharamwalaPeter DeVito
Sep 19, 2012·Annals of Surgical Oncology·Yvette R B M van GestelPeter D Siersema
Sep 25, 2012·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·O TurriniUNKNOWN French Surgical Association (AFC)
Feb 26, 2013·World Journal of Surgery·Orlin BelyaevChristophe A Müller
Apr 13, 2013·Annals of Surgical Oncology·Anasooya AbrahamElizabeth B Habermann
Oct 10, 2013·JAMA : the Journal of the American Medical Association·Helmut OettleHanno Riess
Feb 25, 2014·American Journal of Surgery·David Y LeeFadi Attiyeh
Mar 14, 2014·JAMA Surgery·Bradley N ReamesAmir A Ghaferi
May 23, 2014·The British Journal of Surgery·G A GooikerM W J M Wouters
Sep 6, 2014·Annals of Surgical Oncology·Richard S SwansonDavid P Winchester
Citations
Jun 9, 2016·Updates in Surgery·Claudio Bassi
May 16, 2017·Journal of Surgical Oncology·Linde A D BusweilerJohanna W van Sandick
Jul 7, 2017·Medicine·Jiong-Ze FangJie Zhou
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
Feb 11, 2020·Langenbeck's Archives of Surgery·Rene WarschkowMathias Worni
Oct 28, 2017·Surgery Today·Takefumi KitazawaTomonori Hasegawa
Jun 21, 2020·Journal of Surgical Oncology·Adrienne B ShannonGiorgos C Karakousis
Mar 23, 2017·BMC Surgery·Tim R GlowkaSteffen Manekeller
Aug 29, 2018·Annals of Surgical Oncology·J V GroenJ S D Mieog
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
Oct 4, 2019·International Journal of Surgery·Elinor TanCharbel Sandroussi
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
Apr 4, 2021·Journal of Clinical Medicine·Maximilian BrunnerChristian Krautz
Apr 20, 2021·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Waldemar UhlOrlin Belyaev
Mar 18, 2020·Journal of Visceral Surgery·J R DelperoP Pessaux
Dec 18, 2019·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Jin-Ming WuYu-Wen Tien
Aug 31, 2021·Annals of Medicine and Surgery·S K BurgdorfC P Hansen