Reassessing the role of surgery in the elderly or chronically sick with proximal extrahepatic cholangiocarcinoma.
Publication/Presentation Date
2-1-2021
Abstract
BACKGROUND: Most data on postoperative outcomes among patients with proximal extrahepatic cholangiocarcinoma are reported by single institutions. The purpose of this study was to analyze postoperative outcomes stratified by age and comorbidities.
METHODS: Patients with proximal extrahepatic cholangiocarcinoma who underwent a resection were identified in the National Cancer Database. Pathologic, postoperative, and survival outcomes were compared based on age and Charlson-Deyo comorbidity index.
RESULTS: Among the 1,579 patients, the average age was 66 years, and 9.4% of patients were older than 80 years. Most patients had a Charlson-Deyo score of 0 (72.4%), with the minority having scores of 1 (20.5%) or ≥2 (7.1%). Patients ≥80 years had a higher 90-day mortality rate compared with patients 65 to 79 and(21.3% vs 12.0% vs 7.4%, P < .001). Patients with a Charlson-Deyo score ≥2 had longer duration of stay, greater likelihood of requiring an unplanned readmission, and a higher 90-day mortality rate compared with patients with a lower comorbidity index. Median survival of patients
CONCLUSION: In patients with proximal extrahepatic cholangiocarcinoma, age ≥80 years and greater comorbidity index are associated with increased risk of 90-day mortality and poor overall survival. This suggests that resections in high-risk patient populations should be approached with caution.
Volume
169
Issue
2
First Page
233
Last Page
239
ISSN
1532-7361
Published In/Presented At
Hue, J. J., Sugumar, K., Markt, S. C., Mohamed, A., Selfridge, J. E., Bajor, D., Rothermel, L. D., Hardacre, J. M., Ammori, J. B., Winter, J. M., & Ocuin, L. M. (2021). Reassessing the role of surgery in the elderly or chronically sick with proximal extrahepatic cholangiocarcinoma. Surgery, 169(2), 233–239. https://doi.org/10.1016/j.surg.2020.09.011
Disciplines
Medicine and Health Sciences
PubMedID
33087251
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article
