Long-Term Outcomes After Pancreatectomy for Pancreatic Ductal Adenocarcinoma in Elderly Patients: Special Reference to Postoperative Adjuvant Chemotherapy
- 99 Downloads
The benefit of pancreatectomy for elderly patients with pancreatic ductal adenocarcinoma (PDAC) remains controversial. Moreover, adjuvant chemotherapy (AC) for elderly patients has not been fully evaluated. We investigated the long-term outcomes after pancreatectomy for PDAC in elderly patients with special reference to AC.
The medical records of 123 patients who underwent pancreatectomy for PDAC from 2007 to 2016 were retrospectively reviewed. The patients were divided into two groups: young (<75 years) and elderly patients (≥75 years).
The study population comprised 91 young and 32 elderly patients. The postoperative clinical courses were not different between the two groups. AC was more frequently administered to young (85%) than elderly patients (66%; P = 0.04). The weekly dose of tegafur/gimeracil/oteracil potassium (S1) for AC was significantly lower in elderly (median 423 mg/m2) than young patients (median 491 mg/m2; P = 0.02). The prevalence of adverse events and the completion rate of AC were not significantly different between the two groups. There were no significant differences in recurrence-free survival (P = 0.73) or overall survival (P = 0.68) between the two groups in univariate analysis. Receipt of AC was not a significant independent factor for survival, and completion of planned AC was a significant independent factor for recurrence-free survival and overall survival in multivariate analysis.
The benefit of pancreatectomy for PDAC was the same between young and elderly patients. Completion of planned AC was important, and lowered-dose AC using S1 for elderly patients might be safe and therapeutically useful.
We thank Angela Morben, DVM, ELS, from Edanz Group (www.edanzediting.com/ac), for editing a draft of this manuscript.
YW drafted the manuscript. YW, TS, and SE contributed to the creation of the database of the study population and performed the data extraction and analysis. YW and KN contributed to the study conception and design. YW, YA, and KN performed the pancreatectomy and followed up the study population. YA and KN contributed to the interpretation of the results and revision of the manuscript. All authors discussed the results and commented on the manuscript. TN gave final approval of this article.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
- 17.Sobin L, Gospodarowics M, Wittekind C (2009) TNM classification of malignant tumor, 7th edn. Wiley, New YorkGoogle Scholar
- 21.Rail TS, Reddy DM, Nealon WH et al (2008) The effect of age on short-term outcomes after pancreatic resection: a population-based study. Ann Surg 248:109–117Google Scholar
- 37.Sezai A, Osaka S, Yaoita H et al (2015) Long-term outcome of prosthetic valve replacement in Japanese patients aged 65 years or older: are Guidelines for prosthetic valve selection based on overseas data appropriate for Japanese patients? Ann Thorac Cardiovasc Surg 21:254–260CrossRefPubMedPubMedCentralGoogle Scholar