BACKGROUND: We sought to determine the effects of post-operative radiation therapy (PORT) and lymph node resection (LNR) on survival in patients ≥70 years with pancreatic cancer treated with surgery and chemotherapy. METHODS: An analysis of patients ≥70 years with surgically resected pancreatic cancer who received chemotherapy from the SEER database between 2004-2008 was performed to determine association of PORT and LNR on survival. RESULTS: We identified 961 patients who met inclusion criteria. There was a trend towards increased survival associated with PORT in all patients (P=0.052) and N1 patients (P=0.060) but no benefit in N0 patients (P=0.161). There was no difference in OS based on number of lymph nodes removed in all (P=0.741), N0 (P=0.588), and N1 (P=0.070) patients. MVA for all patients revealed that higher T stage, N1, and high grade tumors were prognostic for increased mortality, while there was decreased mortality with PORT and mild benefit with increased lymph nodes resected (P=0.084). CONCLUSIONS: PORT demonstrated no benefit in survival of pancreatic cancer patients ≥70 who are resected and treated with adjuvant chemotherapy. Future investigation will need to address age as a stratification factor for pancreatic cancer in the adjuvant setting.
BACKGROUND: We sought to determine the effects of post-operative radiation therapy (PORT) and lymph node resection (LNR) on survival in patients ≥70 years with pancreatic cancer treated with surgery and chemotherapy. METHODS: An analysis of patients ≥70 years with surgically resected pancreatic cancer who received chemotherapy from the SEER database between 2004-2008 was performed to determine association of PORT and LNR on survival. RESULTS: We identified 961 patients who met inclusion criteria. There was a trend towards increased survival associated with PORT in all patients (P=0.052) and N1 patients (P=0.060) but no benefit in N0 patients (P=0.161). There was no difference in OS based on number of lymph nodes removed in all (P=0.741), N0 (P=0.588), and N1 (P=0.070) patients. MVA for all patients revealed that higher T stage, N1, and high grade tumors were prognostic for increased mortality, while there was decreased mortality with PORT and mild benefit with increased lymph nodes resected (P=0.084). CONCLUSIONS: PORT demonstrated no benefit in survival of pancreatic cancer patients ≥70 who are resected and treated with adjuvant chemotherapy. Future investigation will need to address age as a stratification factor for pancreatic cancer in the adjuvant setting.
Entities:
Keywords:
Adjuvant radiation; lymph node harvest; outcomes in the elderly population; pancreatic cancer
Authors: J P Neoptolemos; J A Dunn; D D Stocken; J Almond; K Link; H Beger; C Bassi; M Falconi; P Pederzoli; C Dervenis; L Fernandez-Cruz; F Lacaine; A Pap; D Spooner; D J Kerr; H Friess; M W Büchler Journal: Lancet Date: 2001-11-10 Impact factor: 79.321
Authors: J H Klinkenbijl; J Jeekel; T Sahmoud; R van Pel; M L Couvreur; C H Veenhof; J P Arnaud; D G Gonzalez; L T de Wit; A Hennipman; J Wils Journal: Ann Surg Date: 1999-12 Impact factor: 12.969
Authors: Timothy N Showalter; Kathryn A Winter; Adam C Berger; William F Regine; Ross A Abrams; Howard Safran; John P Hoffman; Al B Benson; John S MacDonald; Christopher G Willett Journal: Int J Radiat Oncol Biol Phys Date: 2010-10-08 Impact factor: 7.038
Authors: Hans G Smeenk; Casper H J van Eijck; Wim C Hop; Joris Erdmann; Kheetje C K Tran; Muriel Debois; Eric van Cutsem; Herman van Dekken; Jean H Klinkenbijl; Johannes Jeekel Journal: Ann Surg Date: 2007-11 Impact factor: 12.969
Authors: Michele M Corsini; Robert C Miller; Michael G Haddock; John H Donohue; Michael B Farnell; David M Nagorney; Aminah Jatoi; Robert R McWilliams; George P Kim; Sumita Bhatia; Matthew J Iott; Leonard L Gunderson Journal: J Clin Oncol Date: 2008-07-20 Impact factor: 44.544
Authors: Joseph M Herman; Michael J Swartz; Charles C Hsu; Jordan Winter; Timothy M Pawlik; Elizabeth Sugar; Ray Robinson; Daniel A Laheru; Elizabeth Jaffee; Ralph H Hruban; Kurtis A Campbell; Christopher L Wolfgang; Fariba Asrari; Ross Donehower; Manuel Hidalgo; Luis A Diaz; Charles Yeo; John L Cameron; Richard D Schulick; Ross Abrams Journal: J Clin Oncol Date: 2008-07-20 Impact factor: 44.544