Diagnosis of Pancreatic Cancer after Cholecystectomy in the Elderly.

CHOLECYSTECTOMY; CANCER diagnosis; DELAYED diagnosis; OLDER people; OLDER patients; CHOLECYSTITIS; PANCREATIC tumors

Background: Previous studies evaluating whether recent cholecystectomy is associated with a pancreas cancer diagnosis are limited. We aimed to examine if cholecystectomy was performed more frequently in the year prior to cancer diagnosis than would be expected in a similar non-cancer population. Methods: SEER-Medicare linked files were used to identify patients with pancreatic adenocarcinoma. Cancer diagnoses were considered to be "timely" if within 2 months of cholecystectomy or "delayed" if 2-12 months after cholecystectomy. Clinical factors and survival outcomes were compared using chi-square and Kaplan-Meier analyses. Results: Rate of cholecystectomy in the year prior to diagnosis of cancer was 1.9% for the cancer group, compared to.4% in the non-cancer group (OR = 4.7, 95% CI 4.4-5.1). Differences in the cancer vs non-cancer cohorts at the time of cholecystectomy included a higher age (74 vs 70, P <.0001), more males (49.9% vs 41.7%, P <.0001), and more frequent open technique (21.0% vs 9.4%, P <.0001). Acute pancreatitis was nearly twice as common in the cancer cohort (19.1%) vs the non-cancer cohort (10.7%), P <.0001. There were no differences between patients who had a timely diagnosis after cholecystectomy compared to a delayed diagnosis with regard to age, gender, comorbidity index, race, or rural/urban designation. The rates of localized disease and subsequent resection were also similar between the delayed and timely groups. Overall unadjusted survival was no different between timely and delayed diagnoses, P =.96. Discussion: Elderly patients diagnosed with pancreatic adenocarcinoma are more likely to have had a recent cholecystectomy compared to those without. [ABSTRACT FROM AUTHOR]