The influence of patients' age on the outcome of treatment for pancreatic ductal adenocarcinoma
McNamara, Mairéad G
Hubner, Richard A
Valle, Juan W
De Liguori, CN
AffiliationDepartment of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary, Manchester University Hospitals Foundation Trust
MetadataShow full item record
AbstractOBJECTIVE: The aim of the study was to determine the impact of age on curative management and outcomes of patients with pancreatic ductal adenocarcinoma. METHODS: Patients who underwent resection for pancreatic ductal adenocarcinoma at 2 units were retrospectively reviewed (between 2005 and 2017) and stratified by age (older patients ?70 years). Regression analysis was used to explore factors impacting administration of adjuvant chemotherapy and survival. The Kaplan-Meier method was used to estimate overall survival (time from surgery to death). Statistical significance was set at P < 0.05. RESULTS: From 2005 to 2014, 222 patients were identified (<70 years, n = 128; ?70 years, n = 94). Elderly patients were less likely to receive adjuvant chemotherapy compared with younger patients (odds ratio, 0.57, P = 0.041). Tumor stage, margin, and year of surgery (post-2011 vs pre-2011) were not predictors for chemotherapy receipt (P > 0.05). Frailty was the commonest reason (36.8%) to decline chemotherapy in elderly patients. In patients receiving adjuvant chemotherapy, completion rates (P = 0.32) and overall survival (24 months vs 30 months, P = 0.50) were no different. CONCLUSIONS: Elderly patients demonstrate similar outcomes to younger yet are less likely to commence chemotherapy because of frailty. Holistic preoperative assessment may improve selection for curative treatment.
CitationMalik AK, Lamarca A, Siriwardena AK, O'Reilly D, Deshpande R, Satyadas T, et al. The Influence of Patients' Age on the Outcome of Treatment for Pancreatic Ductal Adenocarcinoma. Pancreas. 2020;49(2):201-7.
- A single center experience in resectable pancreatic ductal adenocarcinoma : the limitations of the surgery-first approach. Critical review of the literature and proposals for practice update.
- Authors: Dumont R, Puleo F, Collignon J, Meurisse N, Chavez M, Seidel L, Gast P, Polus M, Loly C, Delvenne P, Meunier P, Hustinx R, Deroover A, Detry O, Louis E, Martinive P, Van Daele D
- Issue date: 2017 Oct-Dec
- Trajectory of care and use of multimodality therapy in older patients with pancreatic adenocarcinoma.
- Authors: Parmar AD, Vargas GM, Tamirisa NP, Sheffield KM, Riall TS
- Issue date: 2014 Aug
- Preoperative serum C-reactive protein levels and post-operative lymph node ratio are important predictors of survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma.
- Authors: Sanjay P, de Figueiredo RS, Leaver H, Ogston S, Kulli C, Polignano FM, Tait IS
- Issue date: 2012 Mar 10
- The predictors and patterns of the early recurrence of pancreatic ductal adenocarcinoma after pancreatectomy: the influence of pre- and post- operative adjuvant therapy.
- Authors: Suto H, Okano K, Oshima M, Ando Y, Takahashi S, Shibata T, Kamada H, Kobara H, Masaki T, Suzuki Y
- Issue date: 2019 Dec 3
- Completion of Adjuvant Chemotherapy After Upfront Surgical Resection for Pancreatic Cancer Is Uncommon Yet Associated With Improved Survival.
- Authors: Altman AM, Wirth K, Marmor S, Lou E, Chang K, Hui JYC, Tuttle TM, Jensen EH, Denbo JW
- Issue date: 2019 Nov