TY - JOUR
T1 - Evolving management of early stage pancreatic adenocarcinoma in older patients
AU - Nassoiy, Sean
AU - Christopher, Wade
AU - Marcus, Rebecca
AU - Keller, Jennifer
AU - Weiss, Jessica
AU - Chang, Shu Ching
AU - Essner, Richard
AU - Foshag, Leland
AU - Fischer, Trevan
AU - Goldfarb, Melanie
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/1
Y1 - 2023/1
N2 - Background: Due to the aging population, the number of older patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) will continue to rise. Study design: Utilizing the NCDB from 2010 to 2016, patients with early stage, clinically node negative PDAC who were ≥70 years old and had a Whipple were identified. Multivariable logistic regressions were used to determine independent factors for R0 resection and NAT. Cox-proportional-hazards regression analyses examined for the impact of NAT on the risk of death. Results: Of 5086 patients, 51.7% received upfront surgery + adjuvant therapy (UFS + AT), followed by 29.9% UFS only, and the remainder NAT. NAT significantly improved OS compared to a combined cohort of those that had UFS ± AT. NAT retained its independent survival benefit when compared to only patients that had UFS + AT. Conclusion: For older patients diagnosed with early stage PDAC, NAT was associated with improved R0 resection rates and a significant survival benefit when compared to the current standard of care.
AB - Background: Due to the aging population, the number of older patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) will continue to rise. Study design: Utilizing the NCDB from 2010 to 2016, patients with early stage, clinically node negative PDAC who were ≥70 years old and had a Whipple were identified. Multivariable logistic regressions were used to determine independent factors for R0 resection and NAT. Cox-proportional-hazards regression analyses examined for the impact of NAT on the risk of death. Results: Of 5086 patients, 51.7% received upfront surgery + adjuvant therapy (UFS + AT), followed by 29.9% UFS only, and the remainder NAT. NAT significantly improved OS compared to a combined cohort of those that had UFS ± AT. NAT retained its independent survival benefit when compared to only patients that had UFS + AT. Conclusion: For older patients diagnosed with early stage PDAC, NAT was associated with improved R0 resection rates and a significant survival benefit when compared to the current standard of care.
KW - Elderly
KW - Geriatric
KW - Neoadjuvant chemotherapy
KW - Pancreatic ductal adenocarcinoma
KW - Resectable pancreatic cancer
UR - http://www.scopus.com/inward/record.url?scp=85144585188&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2022.07.026
DO - 10.1016/j.amjsurg.2022.07.026
M3 - Article
C2 - 36058752
AN - SCOPUS:85144585188
SN - 0002-9610
VL - 225
SP - 212
EP - 219
JO - The American Journal of Surgery
JF - The American Journal of Surgery
IS - 1
ER -