Outcomes in patients >/= 80 years with a diagnosis of a hepatopancreaticobiliary (HPB) malignancy
AuthorsLewis, Alexandra R
Hubner, Richard A
Valle, Juan W
McNamara, Mairead G
AffiliationThe Christie NHS Foundation Trust, Manchester, UKUniversity of Manchester Medical School, Manchester, UK
MetadataShow full item record
AbstractOlder 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.
CitationLewis 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.
- Use of the Rockwood Clinical Frailty Scale in patients with advanced hepatopancreaticobiliary malignancies.
- Authors: Shah D, Kapacee ZA, Lamarca A, Hubner RA, Valle JW, McNamara MG
- Issue date: 2022 Sep
- Incidence and survival for hepatic, pancreatic and biliary cancers in England between 1998 and 2007.
- Authors: Coupland VH, Kocher HM, Berry DP, Allum W, Linklater KM, Konfortion J, Møller H, Davies EA
- Issue date: 2012 Aug
- Epidemiology of HPB malignancy in the elderly.
- Authors: Pericleous M, Khan SA
- Issue date: 2021 Mar
- Impact of palliative chemotherapy and best supportive care on overall survival and length of hospitalization in patients with incurable Cancer: a 4-year single institution experience in Japan.
- Authors: Murakawa Y, Sakayori M, Otsuka K
- Issue date: 2019 Jun 3
- Clinical Outcomes in Elderly Patients Treated for Oral Cavity Squamous Cell Carcinoma.
- Authors: Chen JJ, Shah JL, Harris JP, Bui TT, Schaberg K, Kong CS, Kaplan MJ, Divi V, Schoppy D, Le QT, Hara WY
- Issue date: 2017 Jul 15