Adjuvant chemotherapy in elderly patients with pancreatic cancer
Background: Adjuvant chemotherapy improves survival for patients with resected pancreatic cancer. Elderly patients are under-represented in Phase III clinical trials, and as a consequence the efficacy of adjuvant therapy in older patients with pancreatic cancer is not clear. We aimed to assess the u...
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| Veröffentlicht in: | British journal of cancer 2014-01, Vol.110 (2), p.313-319 |
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| creator | Nagrial, A M Chang, D K Nguyen, N Q Johns, A L Chantrill, L A Humphris, J L Chin, V T Samra, J S Gill, A J Pajic, M Pinese, M Colvin, E K Scarlett, C J Chou, A Kench, J G Sutherland, R L Horvath, L G Biankin, A V |
| description | Background:
Adjuvant chemotherapy improves survival for patients with resected pancreatic cancer. Elderly patients are under-represented in Phase III clinical trials, and as a consequence the efficacy of adjuvant therapy in older patients with pancreatic cancer is not clear. We aimed to assess the use and efficacy of adjuvant chemotherapy in older patients with pancreatic cancer.
Methods:
We assessed a community cohort of 439 patients with a diagnosis of pancreatic ductal adenocarcinoma who underwent operative resection in centres associated with the Australian Pancreatic Cancer Genome Initiative.
Results:
The median age of the cohort was 67 years. Overall only 47% of all patients received adjuvant therapy. Patients who received adjuvant chemotherapy were predominantly younger, had later stage disease, more lymph node involvement and more evidence of perineural invasion than the group that did not receive adjuvant treatment. Overall, adjuvant chemotherapy was associated with prolonged survival (median 22.1
vs
15.8 months;
P |
| doi_str_mv | 10.1038/bjc.2013.722 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3899761</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3187299731</sourcerecordid><originalsourceid>FETCH-LOGICAL-c480t-6565b9a6dade6eee72d709dbf04faf5b46c2fab1b0dd202a40708a8c62ce617b3</originalsourceid><addsrcrecordid>eNptkcFr2zAUxkXpWNNst56HoRR6qLMnyZasy2go7VoI9LKdhSw9Nw6OnUl2Rv77yiTrsrKT9PR-fPre-wi5oDCjwIuv5crOGFA-k4ydkAnNOUtpweQpmQCATEExOCPnIaxiqaCQH8kZy5jgIPiE3M7datiatk_sEtddv0RvNrukbhNsHPpml2xMX2Pbh-R33S9j1VqP8ckmNl7RfyIfKtME_Hw4p-Tnw_2Pu8d08fz96W6-SG1WQJ-KXOSlMsIZhwIRJXMSlCsryCpT5WUmLKtMSUtwjgEzGUgoTGEFsyioLPmUfNvrboZyjc5GS940euPrtfE73Zla_9tp66V-6baaF0pJQaPA9UHAd78GDL1e18Fi05gWuyFomikmJJXZiF6-Q1fd4Ns43kiB4pzGNU_JzZ6yvgvBY_VmhoIeo9ExGj1Go2M0Ef9yPMAb_CeLCFwdABOsaSof91uHv1zBuII8i1y650JstS_oj9z97-NXFYumuA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1490933115</pqid></control><display><type>article</type><title>Adjuvant chemotherapy in elderly patients with pancreatic cancer</title><source>MEDLINE</source><source>Nature</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Nagrial, A M ; Chang, D K ; Nguyen, N Q ; Johns, A L ; Chantrill, L A ; Humphris, J L ; Chin, V T ; Samra, J S ; Gill, A J ; Pajic, M ; Pinese, M ; Colvin, E K ; Scarlett, C J ; Chou, A ; Kench, J G ; Sutherland, R L ; Horvath, L G ; Biankin, A V</creator><creatorcontrib>Nagrial, A M ; Chang, D K ; Nguyen, N Q ; Johns, A L ; Chantrill, L A ; Humphris, J L ; Chin, V T ; Samra, J S ; Gill, A J ; Pajic, M ; Pinese, M ; Colvin, E K ; Scarlett, C J ; Chou, A ; Kench, J G ; Sutherland, R L ; Horvath, L G ; Biankin, A V ; Australian Pancreatic Cancer Genome Initiative ; Australian Pancreatic Cancer Genome Initiative</creatorcontrib><description>Background:
Adjuvant chemotherapy improves survival for patients with resected pancreatic cancer. Elderly patients are under-represented in Phase III clinical trials, and as a consequence the efficacy of adjuvant therapy in older patients with pancreatic cancer is not clear. We aimed to assess the use and efficacy of adjuvant chemotherapy in older patients with pancreatic cancer.
Methods:
We assessed a community cohort of 439 patients with a diagnosis of pancreatic ductal adenocarcinoma who underwent operative resection in centres associated with the Australian Pancreatic Cancer Genome Initiative.
Results:
The median age of the cohort was 67 years. Overall only 47% of all patients received adjuvant therapy. Patients who received adjuvant chemotherapy were predominantly younger, had later stage disease, more lymph node involvement and more evidence of perineural invasion than the group that did not receive adjuvant treatment. Overall, adjuvant chemotherapy was associated with prolonged survival (median 22.1
vs
15.8 months;
P
<0.0001). Older patients (aged ⩾70) were less likely to receive adjuvant chemotherapy (51.5%
vs
29.8%;
P<
0.0001). Older patients had a particularly poor outcome when adjuvant therapy was not delivered (median survival=13.1 months; HR 1.89, 95% CI: 1.27–2.78,
P=
0.002).
Conclusion:
Patients aged ⩾70 are less likely to receive adjuvant therapy although it is associated with improved outcome. Increased use of adjuvant therapy in older individuals is encouraged as they constitute a large proportion of patients with pancreatic cancer.</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/bjc.2013.722</identifier><identifier>PMID: 24263063</identifier><identifier>CODEN: BJCAAI</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/699/67/1059/99 ; 692/699/67/1504/1713 ; 692/700/1518 ; Age Factors ; Aged ; Antineoplastic Agents - therapeutic use ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Cancer Research ; Carcinoma, Pancreatic Ductal - drug therapy ; Carcinoma, Pancreatic Ductal - pathology ; Carcinoma, Pancreatic Ductal - surgery ; Chemotherapy, Adjuvant ; Clinical Study ; Cohort Studies ; Drug Resistance ; Epidemiology ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Lymph Nodes - drug effects ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Male ; Medical sciences ; Molecular Medicine ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Oncology ; Pancreatic cancer ; Pancreatic Neoplasms - drug therapy ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - surgery ; Prognosis ; Tumors</subject><ispartof>British journal of cancer, 2014-01, Vol.110 (2), p.313-319</ispartof><rights>The Author(s) 2014</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Jan 21, 2014</rights><rights>Copyright © 2014 Cancer Research UK 2014 Cancer Research UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c480t-6565b9a6dade6eee72d709dbf04faf5b46c2fab1b0dd202a40708a8c62ce617b3</citedby><cites>FETCH-LOGICAL-c480t-6565b9a6dade6eee72d709dbf04faf5b46c2fab1b0dd202a40708a8c62ce617b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899761/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899761/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,27928,27929,53795,53797</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28239054$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24263063$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nagrial, A M</creatorcontrib><creatorcontrib>Chang, D K</creatorcontrib><creatorcontrib>Nguyen, N Q</creatorcontrib><creatorcontrib>Johns, A L</creatorcontrib><creatorcontrib>Chantrill, L A</creatorcontrib><creatorcontrib>Humphris, J L</creatorcontrib><creatorcontrib>Chin, V T</creatorcontrib><creatorcontrib>Samra, J S</creatorcontrib><creatorcontrib>Gill, A J</creatorcontrib><creatorcontrib>Pajic, M</creatorcontrib><creatorcontrib>Pinese, M</creatorcontrib><creatorcontrib>Colvin, E K</creatorcontrib><creatorcontrib>Scarlett, C J</creatorcontrib><creatorcontrib>Chou, A</creatorcontrib><creatorcontrib>Kench, J G</creatorcontrib><creatorcontrib>Sutherland, R L</creatorcontrib><creatorcontrib>Horvath, L G</creatorcontrib><creatorcontrib>Biankin, A V</creatorcontrib><creatorcontrib>Australian Pancreatic Cancer Genome Initiative</creatorcontrib><creatorcontrib>Australian Pancreatic Cancer Genome Initiative</creatorcontrib><title>Adjuvant chemotherapy in elderly patients with pancreatic cancer</title><title>British journal of cancer</title><addtitle>Br J Cancer</addtitle><addtitle>Br J Cancer</addtitle><description>Background:
Adjuvant chemotherapy improves survival for patients with resected pancreatic cancer. Elderly patients are under-represented in Phase III clinical trials, and as a consequence the efficacy of adjuvant therapy in older patients with pancreatic cancer is not clear. We aimed to assess the use and efficacy of adjuvant chemotherapy in older patients with pancreatic cancer.
Methods:
We assessed a community cohort of 439 patients with a diagnosis of pancreatic ductal adenocarcinoma who underwent operative resection in centres associated with the Australian Pancreatic Cancer Genome Initiative.
Results:
The median age of the cohort was 67 years. Overall only 47% of all patients received adjuvant therapy. Patients who received adjuvant chemotherapy were predominantly younger, had later stage disease, more lymph node involvement and more evidence of perineural invasion than the group that did not receive adjuvant treatment. Overall, adjuvant chemotherapy was associated with prolonged survival (median 22.1
vs
15.8 months;
P
<0.0001). Older patients (aged ⩾70) were less likely to receive adjuvant chemotherapy (51.5%
vs
29.8%;
P<
0.0001). Older patients had a particularly poor outcome when adjuvant therapy was not delivered (median survival=13.1 months; HR 1.89, 95% CI: 1.27–2.78,
P=
0.002).
Conclusion:
Patients aged ⩾70 are less likely to receive adjuvant therapy although it is associated with improved outcome. Increased use of adjuvant therapy in older individuals is encouraged as they constitute a large proportion of patients with pancreatic cancer.</description><subject>692/699/67/1059/99</subject><subject>692/699/67/1504/1713</subject><subject>692/700/1518</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cancer Research</subject><subject>Carcinoma, Pancreatic Ductal - drug therapy</subject><subject>Carcinoma, Pancreatic Ductal - pathology</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Chemotherapy, Adjuvant</subject><subject>Clinical Study</subject><subject>Cohort Studies</subject><subject>Drug Resistance</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Lymph Nodes - drug effects</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Molecular Medicine</subject><subject>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</subject><subject>Oncology</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - drug therapy</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Prognosis</subject><subject>Tumors</subject><issn>0007-0920</issn><issn>1532-1827</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNptkcFr2zAUxkXpWNNst56HoRR6qLMnyZasy2go7VoI9LKdhSw9Nw6OnUl2Rv77yiTrsrKT9PR-fPre-wi5oDCjwIuv5crOGFA-k4ydkAnNOUtpweQpmQCATEExOCPnIaxiqaCQH8kZy5jgIPiE3M7datiatk_sEtddv0RvNrukbhNsHPpml2xMX2Pbh-R33S9j1VqP8ckmNl7RfyIfKtME_Hw4p-Tnw_2Pu8d08fz96W6-SG1WQJ-KXOSlMsIZhwIRJXMSlCsryCpT5WUmLKtMSUtwjgEzGUgoTGEFsyioLPmUfNvrboZyjc5GS940euPrtfE73Zla_9tp66V-6baaF0pJQaPA9UHAd78GDL1e18Fi05gWuyFomikmJJXZiF6-Q1fd4Ns43kiB4pzGNU_JzZ6yvgvBY_VmhoIeo9ExGj1Go2M0Ef9yPMAb_CeLCFwdABOsaSof91uHv1zBuII8i1y650JstS_oj9z97-NXFYumuA</recordid><startdate>20140121</startdate><enddate>20140121</enddate><creator>Nagrial, A M</creator><creator>Chang, D K</creator><creator>Nguyen, N Q</creator><creator>Johns, A L</creator><creator>Chantrill, L A</creator><creator>Humphris, J L</creator><creator>Chin, V T</creator><creator>Samra, J S</creator><creator>Gill, A J</creator><creator>Pajic, M</creator><creator>Pinese, M</creator><creator>Colvin, E K</creator><creator>Scarlett, C J</creator><creator>Chou, A</creator><creator>Kench, J G</creator><creator>Sutherland, R L</creator><creator>Horvath, L G</creator><creator>Biankin, A V</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140121</creationdate><title>Adjuvant chemotherapy in elderly patients with pancreatic cancer</title><author>Nagrial, A M ; Chang, D K ; Nguyen, N Q ; Johns, A L ; Chantrill, L A ; Humphris, J L ; Chin, V T ; Samra, J S ; Gill, A J ; Pajic, M ; Pinese, M ; Colvin, E K ; Scarlett, C J ; Chou, A ; Kench, J G ; Sutherland, R L ; Horvath, L G ; Biankin, A V</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-6565b9a6dade6eee72d709dbf04faf5b46c2fab1b0dd202a40708a8c62ce617b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>692/699/67/1059/99</topic><topic>692/699/67/1504/1713</topic><topic>692/700/1518</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cancer Research</topic><topic>Carcinoma, Pancreatic Ductal - drug therapy</topic><topic>Carcinoma, Pancreatic Ductal - pathology</topic><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Chemotherapy, Adjuvant</topic><topic>Clinical Study</topic><topic>Cohort Studies</topic><topic>Drug Resistance</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Lymph Nodes - drug effects</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Molecular Medicine</topic><topic>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</topic><topic>Oncology</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - drug therapy</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Prognosis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nagrial, A M</creatorcontrib><creatorcontrib>Chang, D K</creatorcontrib><creatorcontrib>Nguyen, N Q</creatorcontrib><creatorcontrib>Johns, A L</creatorcontrib><creatorcontrib>Chantrill, L A</creatorcontrib><creatorcontrib>Humphris, J L</creatorcontrib><creatorcontrib>Chin, V T</creatorcontrib><creatorcontrib>Samra, J S</creatorcontrib><creatorcontrib>Gill, A J</creatorcontrib><creatorcontrib>Pajic, M</creatorcontrib><creatorcontrib>Pinese, M</creatorcontrib><creatorcontrib>Colvin, E K</creatorcontrib><creatorcontrib>Scarlett, C J</creatorcontrib><creatorcontrib>Chou, A</creatorcontrib><creatorcontrib>Kench, J G</creatorcontrib><creatorcontrib>Sutherland, R L</creatorcontrib><creatorcontrib>Horvath, L G</creatorcontrib><creatorcontrib>Biankin, A V</creatorcontrib><creatorcontrib>Australian Pancreatic Cancer Genome Initiative</creatorcontrib><creatorcontrib>Australian Pancreatic Cancer Genome Initiative</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nagrial, A M</au><au>Chang, D K</au><au>Nguyen, N Q</au><au>Johns, A L</au><au>Chantrill, L A</au><au>Humphris, J L</au><au>Chin, V T</au><au>Samra, J S</au><au>Gill, A J</au><au>Pajic, M</au><au>Pinese, M</au><au>Colvin, E K</au><au>Scarlett, C J</au><au>Chou, A</au><au>Kench, J G</au><au>Sutherland, R L</au><au>Horvath, L G</au><au>Biankin, A V</au><aucorp>Australian Pancreatic Cancer Genome Initiative</aucorp><aucorp>Australian Pancreatic Cancer Genome Initiative</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adjuvant chemotherapy in elderly patients with pancreatic cancer</atitle><jtitle>British journal of cancer</jtitle><stitle>Br J Cancer</stitle><addtitle>Br J Cancer</addtitle><date>2014-01-21</date><risdate>2014</risdate><volume>110</volume><issue>2</issue><spage>313</spage><epage>319</epage><pages>313-319</pages><issn>0007-0920</issn><eissn>1532-1827</eissn><coden>BJCAAI</coden><abstract>Background:
Adjuvant chemotherapy improves survival for patients with resected pancreatic cancer. Elderly patients are under-represented in Phase III clinical trials, and as a consequence the efficacy of adjuvant therapy in older patients with pancreatic cancer is not clear. We aimed to assess the use and efficacy of adjuvant chemotherapy in older patients with pancreatic cancer.
Methods:
We assessed a community cohort of 439 patients with a diagnosis of pancreatic ductal adenocarcinoma who underwent operative resection in centres associated with the Australian Pancreatic Cancer Genome Initiative.
Results:
The median age of the cohort was 67 years. Overall only 47% of all patients received adjuvant therapy. Patients who received adjuvant chemotherapy were predominantly younger, had later stage disease, more lymph node involvement and more evidence of perineural invasion than the group that did not receive adjuvant treatment. Overall, adjuvant chemotherapy was associated with prolonged survival (median 22.1
vs
15.8 months;
P
<0.0001). Older patients (aged ⩾70) were less likely to receive adjuvant chemotherapy (51.5%
vs
29.8%;
P<
0.0001). Older patients had a particularly poor outcome when adjuvant therapy was not delivered (median survival=13.1 months; HR 1.89, 95% CI: 1.27–2.78,
P=
0.002).
Conclusion:
Patients aged ⩾70 are less likely to receive adjuvant therapy although it is associated with improved outcome. Increased use of adjuvant therapy in older individuals is encouraged as they constitute a large proportion of patients with pancreatic cancer.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>24263063</pmid><doi>10.1038/bjc.2013.722</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of cancer, 2014-01, Vol.110 (2), p.313-319 |
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| subjects | 692/699/67/1059/99 692/699/67/1504/1713 692/700/1518 Age Factors Aged Antineoplastic Agents - therapeutic use Biological and medical sciences Biomedical and Life Sciences Biomedicine Cancer Research Carcinoma, Pancreatic Ductal - drug therapy Carcinoma, Pancreatic Ductal - pathology Carcinoma, Pancreatic Ductal - surgery Chemotherapy, Adjuvant Clinical Study Cohort Studies Drug Resistance Epidemiology Female Gastroenterology. Liver. Pancreas. Abdomen Humans Liver. Biliary tract. Portal circulation. Exocrine pancreas Lymph Nodes - drug effects Lymph Nodes - pathology Lymphatic Metastasis Male Medical sciences Molecular Medicine Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Oncology Pancreatic cancer Pancreatic Neoplasms - drug therapy Pancreatic Neoplasms - pathology Pancreatic Neoplasms - surgery Prognosis Tumors |
| title | Adjuvant chemotherapy in elderly patients with pancreatic cancer |
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