Age-Related Differences in the Prognosis of Pancreatic Cancer According to Perioperative Systemic Therapy.

Abstract

OBJECTIVES:

In this study, we retrospectively assessed the feasibility and prognostic efficacy of perioperative chemo(radio)therapy for pancreatic cancer (PC) patients according to age.

METHODS:

A total of 556 consecutive patients who underwent curative-intent pancreatectomy for PC between 2000 and 2018 were enrolled.

RESULTS:

Of the 556 patients who underwent resection, 95 (17%) were elderly (age, ≥75 years). Postoperative complications did not significantly differ between the 2 age groups, and postoperative prognoses were also similar (recurrence-free survival [RFS], P = 0.68; overall survival [OS], P = 0.28). In this cohort, 103 patients (19%) underwent preoperative chemo(radio)therapy, and 417 (77%) underwent postoperative chemotherapy. Perioperative therapy was found to be significantly beneficial for younger patients (preoperative therapy: RFS, P = 0.006; OS, P < 0.001; postoperative therapy: RFS, P < 0.001; OS, P < 0.001). Conversely, no significant survival benefit of perioperative therapy was found for the elderly (preoperative therapy: RFS, P = 0.28; OS, P = 0.44; postoperative therapy: RFS, P = 0.77; OS, P = 0.08).

CONCLUSIONS:

This study demonstrated that, although perioperative therapy is feasible for selected elderly patients with PC, this approach might not be as beneficial as it is for younger PC patients.

• Authors: Fuminori Sonohara, Suguru Yamada, Keisuke Kurimoto, Yoshikuni Inokawa, Hideki Takami, Masamichi Hayashi, Dai Shimizu, Norifumi Hattori, Mitsuro Kanda, Chie Tanaka, Goro Nakayama, Masahiko Koike, Tsutomu Fujii, Yasuhiro Kodera
• Journal: Pancreas (Pancreas) Vol. 50 Issue 1 Pg. 37-46 (01 01 2021) ISSN: 1536-4828 [Electronic] United States
• PMID: 33370021 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Chemoradiotherapy, Adjuvant
• Chemotherapy, Adjuvant
• Clinical Decision-Making
• Disease Progression
• Feasibility Studies
• Female
• Humans
• Male
• Middle Aged
• Neoadjuvant Therapy (adverse effects, mortality)
• Neoplasm Recurrence, Local
• Pancreatectomy (adverse effects, mortality)
• Pancreatic Neoplasms (diagnosis, metabolism, therapy)
• Progression-Free Survival
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Time Factors