L J H Brada1, M S Walma2, R M van Dam3, J de Vos-Geelen4, I H de Hingh5, G J Creemers6, M S Liem7, L J Mekenkamp8, V E de Meijer9, D J A de Groot10, G A Patijn11, J W B de Groot12, S Festen13, E D Kerver14, M W J Stommel15, M R Meijerink16, K Bosscha17, J F Pruijt18, M B Polée19, J A Ropela20, G A Cirkel21, M Los21, J W Wilmink22, N Haj Mohammad21, H C van Santvoort23, M G Besselink24, I Q Molenaar25. 1. Dept. of Surgery, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands; Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: l.j.brada@amsterdamumc.nl. 2. Dept. of Surgery, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands; Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 3. Dept. of Surgery, Maastricht UMC, Maastricht, the Netherlands. 4. Dept. of Internal Medicine, Div. of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands. 5. Dept. of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Dept. of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands. 6. Dept. of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands. 7. Dept. of Surgery, Medical Spectrum Twente, Enschede, the Netherlands. 8. Dept. of Medical Oncology, Medical Spectrum Twente, Enschede, the Netherlands. 9. Dept. of Surgery, UMC Groningen, Groningen, the Netherlands. 10. Dept. of Medical Oncology, UMC Groningen, Groningen, the Netherlands. 11. Dept. of Surgery, Isala, Zwolle, the Netherlands. 12. Isala Oncology Center, Isala, Zwolle, the Netherlands. 13. Dept. of Surgery, OLVG, Amsterdam, the Netherlands. 14. Dept. of Medical Oncology, OLVG, Amsterdam, the Netherlands. 15. Dept. of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. 16. Dept. of Radiology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands. 17. Dept. of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands. 18. Dept. of Medical Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands. 19. Dept. of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, the Netherlands. 20. Dept. of Medical Oncology, St Jansdal Hospital, Harderwijk, the Netherlands. 21. Dept. of Medical Oncology, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands. 22. Dept. of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 23. Dept. of Surgery, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands. 24. Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 25. Dept. of Surgery, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands. Electronic address: i.q.molenaar@umcutrecht.nl.
Abstract
BACKGROUND: The treatment options for patients with locally advanced pancreatic cancer (LAPC) have improved in recent years and consequently survival has increased. It is unknown, however, if elderly patients benefit from these improvements in therapy. With the ongoing aging of the patient population and an increasing incidence of pancreatic cancer, this patient group becomes more relevant. This study aims to clarify the association between increasing age, treatment and overall survival in patients with LAPC. METHODS: Post-hoc analysis of a multicenter registry including consecutive patients with LAPC, who were registered in 14 centers of the Dutch Pancreatic Cancer Group (April 2015-December 2017). Patients were divided in three groups according to age (<65, 65-74 and ≥75 years). Primary outcome was overall survival stratified by primary treatment strategy. Multivariable regression analyses were performed to adjust for possible confounders. RESULTS: Overall, 422 patients with LAPC were included; 162 patients (38%) aged <65 years, 182 patients (43%) aged 65-74 and 78 patients (19%) aged ≥75 years. Chemotherapy was administered in 86%, 81% and 50% of the patients in the different age groups (p<0.01). Median overall survival was 12, 11 and 7 months for the different age groups (p<0.01).Patients treated with chemotherapy showed comparable median overall survival of 13, 14 and 10 months for the different age groups (p=0.11). When adjusted for confounders, age was not associated with overall survival. CONCLUSION: Elderly patients are less likely to be treated with chemotherapy, but when treated with chemotherapy, their survival is comparable to younger patients.
BACKGROUND: The treatment options for patients with locally advanced pancreatic cancer (LAPC) have improved in recent years and consequently survival has increased. It is unknown, however, if elderly patients benefit from these improvements in therapy. With the ongoing aging of the patient population and an increasing incidence of pancreatic cancer, this patient group becomes more relevant. This study aims to clarify the association between increasing age, treatment and overall survival in patients with LAPC. METHODS: Post-hoc analysis of a multicenter registry including consecutive patients with LAPC, who were registered in 14 centers of the Dutch Pancreatic Cancer Group (April 2015-December 2017). Patients were divided in three groups according to age (<65, 65-74 and ≥75 years). Primary outcome was overall survival stratified by primary treatment strategy. Multivariable regression analyses were performed to adjust for possible confounders. RESULTS: Overall, 422 patients with LAPC were included; 162 patients (38%) aged <65 years, 182 patients (43%) aged 65-74 and 78 patients (19%) aged ≥75 years. Chemotherapy was administered in 86%, 81% and 50% of the patients in the different age groups (p<0.01). Median overall survival was 12, 11 and 7 months for the different age groups (p<0.01).Patients treated with chemotherapy showed comparable median overall survival of 13, 14 and 10 months for the different age groups (p=0.11). When adjusted for confounders, age was not associated with overall survival. CONCLUSION: Elderly patients are less likely to be treated with chemotherapy, but when treated with chemotherapy, their survival is comparable to younger patients.