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Pancreatic cancer surgery can help those over 80, Jefferson surgeons find

PHILADELPHIA-Age doesn't necessarily have to be the deciding factor for cancer surgery, Jefferson Medical College surgeons have found.

Pancreatic cancer surgeon Charles J. Yeo, M.D., Samuel D. Gross Professor and chair of surgery at Jefferson Medical College of Thomas Jefferson University and Thomas Jefferson University Hospital in Philadelphia and Jefferson's Kimmel Cancer Center, and his colleagues studied records of pancreatic surgery during the last 35 years at Johns Hopkins University in Baltimore and found that contrary to what many both in and out of medicine may believe, major pancreatic cancer surgery can successfully be performed on patients in their 80s, 90s and even older.

In the study, reported recently in the Journal of Gastrointestinal Surgery, Dr. Yeo and co-workers examined records of nearly 2,700 cases of the standard Whipple operation for pancreatic disease, including cancer. Of these, about 1,000 operations were performed in the last four years. The Whipple procedure entails the surgical removal of the head of the pancreas, the duodenum (part of the small intestine), part of the common bile duct, the gallbladder and sometimes a portion of the stomach.

Of this group, 207 patients were 80 years old or older. Those who were 80 to 89 years of age had a mortality rate of 4.1 percent (8 of 197), and a complication rate of 52.8 percent. Those younger than 80 years old had a mortality rate of 1.7 percent, with a complication rate of 41.6 percent. Of 10 patients 90 or older, the researchers reported no deaths after surgery, though half had complications. Of those 80 to 89 years old, 59.1 percent lived for at least one year, while 60 percent of patients 90 years and older lived that long after surgery.

Such complication rates for individuals at least 80 years old are what would be expected, Dr. Yeo says, and involve conditions that afflict many that age, such as heart disease, diabetes and high blood pressure. "The genera
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13-Jun-2006


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