Comparison of Outcomes and the Use of Multimodality Therapy in Young and Elderly People Undergoing Surgical Resection of Pancreatic Cancer

• Autores: Andrew S. Barbas, Ryan S. Turley, Eugene P. Ceppa, Srinevas K. Reddy, Dan G. Blazer, Bryan M. Clary, Theodore N. Pappas, Douglas S. Tyler, Rebekah R. White, Sandhya A. Lagoo
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 60, Nº. 2, 2012, págs. 344-350
• Idioma: inglés
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• Resumen

  • Objectives: To compare outcomes and the use of multimodality therapy in young and elderly people with pancreatic cancer undergoing surgical resection.

    Design: Retrospective, single-institution study.

    Setting: National Cancer Institute/National Comprehensive Cancer Network cancer center.

    Participants: Two hundred three individuals who underwent pancreaticoduodenectomy for pancreatic adenocarcinoma at Duke University Medical Center comprised the study population. Participants were divided into three groups based on age (<65, n = 97; 65�74, n = 74; ?75, N = 32).

    Measurements: Perioperative outcomes, the use of multimodality therapy, and overall survival of the different age groups were compared.

    Results: Similar rates of perioperative mortality and morbidity were observed in all age groups, but elderly adults were more likely to be discharged to a rehabilitation or skilled nursing facility. A similar proportion of participants received neoadjuvant therapy, but a smaller proportion of elderly participants received adjuvant therapy. Overall survival was similar between the age groups. Predictors of poorer overall survival included coronary artery disease, positive resection margin, and less-differentiated tumor histology. Treatment with neoadjuvant and adjuvant therapy were predictors of better overall survival.

    Conclusion: Carefully selected elderly individuals experience similar perioperative outcomes and overall survival to those of younger individuals after resection of pancreatic cancer. There appears to be a significant disparity in the use of adjuvant therapy between young and elderly individuals.