Assessing the Role of Operative Intervention in Elderly Patients With Nonfunctional Pancreatic Neuroendocrine Neoplasms.
Publication/Presentation Date
4-1-2022
Abstract
OBJECTIVES: Resection of locoregional pancreatic neuroendocrine neoplasms (PanNENs) is typically recommended, but there is a paucity of data on the management of elderly patients.
METHODS: The National Cancer Database (2004-2016) was queried for patients 80 years or older with localized PanNENs. Patients were grouped as nonoperative or operative management. Postoperative outcomes and survival were compared.
RESULTS: In total, 591 patients were included: 202 underwent resection, and 389 did not. Increasing age and pancreatic head tumors were associated with lower likelihood of resection. The overall 90-day mortality rate was 6.4%, which was higher for pancreatoduodenectomy than distal pancreatectomy (13.6% vs 5.1%, respectively). Operatively managed patients had longer median survival (80.8 vs 45.0 months, P < 0.001), and this association was independent of tumor location. On multivariable Cox regression, resection remained associated with longer survival (hazard ratio, 0.69; 95% confidence interval, 0.50-0.95). Among operatively managed patients, age and tumor location were not associated with survival; however, greater comorbidity and high-risk tumor-specific features were associated with worse survival.
CONCLUSIONS: Resection of nonfunctional PanNENs in elderly patients is associated with improved survival compared with nonoperative management. Resection could be considered in appropriate operative candidates, regardless of tumor location, but the perioperative mortality rate must be considered.
Volume
51
Issue
4
First Page
380
Last Page
387
ISSN
1536-4828
Published In/Presented At
Hue, J. J., Sugumar, K., Mohamed, A., Selfridge, J. E., Bajor, D., Hardacre, J. M., Ammori, J. B., Rothermel, L. D., Winter, J. M., & Ocuin, L. M. (2022). Assessing the Role of Operative Intervention in Elderly Patients With Nonfunctional Pancreatic Neuroendocrine Neoplasms. Pancreas, 51(4), 380–387. https://doi.org/10.1097/MPA.0000000000002023
Disciplines
Medicine and Health Sciences
PubMedID
35695765
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article
