Pancreatic resection in the octogenarian

A safe option for pancreatic malignancy

Ioannis Hatzaras, Carl Schmidt, Dori Klemanski, Peter Muscarella, W. Scott Melvin, E. Christopher Ellison, Mark Bloomston

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Background: The incidence of pancreatic cancer is age related; patients older than the age of 65 represent 60% of all cases. We assessed our institution's experience and outcomes with pancreatic resection for malignancy in patients in their ninth decade. Study Design: We reviewed records of patients undergoing pancreatic resection for malignancy at our institution between 1990 and 2007. Demographics, laboratory, treatment, and outcomes data were gathered. Comparisons were made between patients older and younger than the age of 80. Survival was analyzed using the Kaplan-Meier method and comparisons between groups were performed using the log-rank test. Regression methods were used to evaluate predictors of outcomes. Results: There were 517 pancreatic resections for cancer reviewed. Of these, 27 patients were 80 years or older (age range 80 to 91 years), compared with 490 patients less than 80 (range 20 to 79 years). The distribution of clinical characteristics was similar between the 2 groups. The majority of patients undergoing pancreatic resection harbored a mass in the head of the pancreas, so the most common procedure was pancreaticoduodenectomy (n = 398, 78%). There were no significant differences in complication rates for younger and older groups (59% vs 52%, respectively, p = 0.4), median length of stay (11 vs 12 days, p = 0.33), or perioperative mortality rates (3.7% vs 3.7%, p = 1.0). Overall survival between the 2 groups was similar (21.9 vs 33.3 months, p = 0.18). Conclusions: Pancreatectomy for malignancy is a safe option for the elderly. Patients older than age 80 achieved similar results, with similar rates of perioperative complications and mortality. Pancreatectomy for cancer offers a similar survival benefit in both groups.

Original languageEnglish (US)
Pages (from-to)373-377
Number of pages5
JournalJournal of the American College of Surgeons
Volume212
Issue number3
DOIs
StatePublished - Mar 2011
Externally publishedYes

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Neoplasms
Pancreatectomy
Pancreatic Neoplasms
Survival
Hospital Distribution Systems
Pancreaticoduodenectomy
Mortality
Pancreas
Length of Stay
Demography
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Pancreatic resection in the octogenarian : A safe option for pancreatic malignancy. / Hatzaras, Ioannis; Schmidt, Carl; Klemanski, Dori; Muscarella, Peter; Melvin, W. Scott; Ellison, E. Christopher; Bloomston, Mark.

In: Journal of the American College of Surgeons, Vol. 212, No. 3, 03.2011, p. 373-377.

Research output: Contribution to journalArticle

Hatzaras, Ioannis ; Schmidt, Carl ; Klemanski, Dori ; Muscarella, Peter ; Melvin, W. Scott ; Ellison, E. Christopher ; Bloomston, Mark. / Pancreatic resection in the octogenarian : A safe option for pancreatic malignancy. In: Journal of the American College of Surgeons. 2011 ; Vol. 212, No. 3. pp. 373-377.
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abstract = "Background: The incidence of pancreatic cancer is age related; patients older than the age of 65 represent 60{\%} of all cases. We assessed our institution's experience and outcomes with pancreatic resection for malignancy in patients in their ninth decade. Study Design: We reviewed records of patients undergoing pancreatic resection for malignancy at our institution between 1990 and 2007. Demographics, laboratory, treatment, and outcomes data were gathered. Comparisons were made between patients older and younger than the age of 80. Survival was analyzed using the Kaplan-Meier method and comparisons between groups were performed using the log-rank test. Regression methods were used to evaluate predictors of outcomes. Results: There were 517 pancreatic resections for cancer reviewed. Of these, 27 patients were 80 years or older (age range 80 to 91 years), compared with 490 patients less than 80 (range 20 to 79 years). The distribution of clinical characteristics was similar between the 2 groups. The majority of patients undergoing pancreatic resection harbored a mass in the head of the pancreas, so the most common procedure was pancreaticoduodenectomy (n = 398, 78{\%}). There were no significant differences in complication rates for younger and older groups (59{\%} vs 52{\%}, respectively, p = 0.4), median length of stay (11 vs 12 days, p = 0.33), or perioperative mortality rates (3.7{\%} vs 3.7{\%}, p = 1.0). Overall survival between the 2 groups was similar (21.9 vs 33.3 months, p = 0.18). Conclusions: Pancreatectomy for malignancy is a safe option for the elderly. Patients older than age 80 achieved similar results, with similar rates of perioperative complications and mortality. Pancreatectomy for cancer offers a similar survival benefit in both groups.",
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