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    Outcomes in patients >/= 80 years with a diagnosis of a hepatopancreaticobiliary (HPB) malignancy

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    Authors
    Lewis, Alexandra R
    Cipriano, C
    Wang, Xin
    Ward, R
    Fitzpatrick, A
    Scott, ARM
    Rashed, A
    Raja, Hussain
    Lamarca, Angela
    Hubner, Richard A
    Valle, Juan W
    McNamara, Mairead G
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    Affiliation
    The Christie NHS Foundation Trust, Manchester, UKUniversity of Manchester Medical School, Manchester, UK
    Issue Date
    2019
    
    Metadata
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    Abstract
    Older patients are underrepresented in oncological clinical trials. The incidence of hepatopancreaticobiliary (HPB) malignancies is higher in older patients, but data on outcomes are lacking. This study assessed patient outcomes in those?<?80 and?³?80 years with a HPB malignancy seen at a tertiary referral centre, The Christie NHS Foundation Trust. Data on patients with a HPB malignancy were collected retrospectively between 2012 and 2017 via on-line case-note review. Survival was calculated using the Kaplan-Meier method and prognostic factors using log-rank analysis. Of 1421 patients, 10% were?³?80 years. Of patients?<?80 and?³?80 years, 56% and 57% had pancreas cancer, 39% and 36% biliary tract cancer, and 5% and 7% had hepatocellular carcinoma, respectively. Amongst patients?³?80 years, 75% had an Eastern Cooperative Oncology Group performance status (ECOG PS) 0-2. Patients?³?80 years had higher rates of comorbidity; 28% received systemic anti-cancer therapy (SACT), compared with 62% of patients?<?80 years. Best supportive care (BSC) was instituted in 44% of older patients, compared with 13% in those?<?80 years. Of patients?³?80 years who received SACT, 82% received monotherapy. Median overall survival (OS) for patients receiving palliative SACT was 10.07 months (95% CI 8.89-11.08) and 10.10 months (95% CI 6.30-12.30) in patients?<?80 and?³?80 years, respectively, p 0.41; ECOG PS (p?<?0.001) was prognostic for OS in older patients but Adult Comorbidity Evaluation-27 comorbidity score (p?=?0.07, when comparing groups of ACE score?²?1 and?>?1) was not. Baseline factors were similar in both age cohorts, but more comorbidities were present in older patients. Older patients were less likely to receive SACT, but when they did, they had an equivalent benefit in OS to younger patients.
    Citation
    Lewis AR, Cipriano C, Wang X, Ward R, Fitzpatrick A, Scott ARM, et al. Outcomes in patients >/= 80 years with a diagnosis of a hepatopancreaticobiliary (HPB) malignancy. Med Oncol. 2019 Sep 6;36(10):85.
    Journal
    Medical Oncology
    URI
    http://hdl.handle.net/10541/622168
    DOI
    10.1007/s12032-019-1310-0
    PubMed ID
    31493088
    Additional Links
    https://dx.doi.org/10.1007/s12032-019-1310-0
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1007/s12032-019-1310-0
    Scopus Count
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