The influence of patients' age on the outcome of treatment for pancreatic ductal adenocarcinoma
Authors
Malik, AKLamarca, Angela
Siriwardena, AK
O'Reilly, D
Deshpande R
Satyadas, T
Jamdar, S
Sheen, A
McNamara, Mairéad G
Hubner, Richard A
Valle, Juan W
De Liguori, CN
Affiliation
Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary, Manchester University Hospitals Foundation TrustIssue Date
2020
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OBJECTIVE: 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.Citation
Malik 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.Journal
PancreasDOI
10.1097/MPA.0000000000001486PubMed ID
32011535Additional Links
https://dx.doi.org/10.1097/MPA.0000000000001486Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1097/MPA.0000000000001486
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