Efficacy of chemotherapy in elderly patients with unresectable pancreatic cancer: a multicenter review of 895 patients
Abstract Background The efficacy of chemotherapy for unresectable pancreatic cancer has improved. However, it is occasionally difficult to make treatment decisions for elderly patients. We reviewed the outcomes of elderly patients with unresectable pancreatic cancer by using a large cohort and evalu...
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| Format: | Article |
| Language: | English |
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BMC
2017-05-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12876-017-0623-8 |
| _version_ | 1818230346662019072 |
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| author | Taira Kuroda Teru Kumagi Tomoyuki Yokota Nobuaki Azemoto Aki Hasebe Hirotaka Seike Mari Nishiyama Nobu Inada Naozumi Shibata Hideki Miyata Tomoe Kawamura Yusuke Imai Akiko Ueno-Toshimori Yoshinori Tanaka Takashi Terao Yoshiki Imamura Mitsuhito Koizumi Hirofumi Yamanishi Yoshinori Ohno Yoichi Hiasa on behalf of the Ehime Pancreato-Cholangiology (EPOCH) Study Group |
| author_facet | Taira Kuroda Teru Kumagi Tomoyuki Yokota Nobuaki Azemoto Aki Hasebe Hirotaka Seike Mari Nishiyama Nobu Inada Naozumi Shibata Hideki Miyata Tomoe Kawamura Yusuke Imai Akiko Ueno-Toshimori Yoshinori Tanaka Takashi Terao Yoshiki Imamura Mitsuhito Koizumi Hirofumi Yamanishi Yoshinori Ohno Yoichi Hiasa on behalf of the Ehime Pancreato-Cholangiology (EPOCH) Study Group |
| author_sort | Taira Kuroda |
| collection | DOAJ |
| description | Abstract Background The efficacy of chemotherapy for unresectable pancreatic cancer has improved. However, it is occasionally difficult to make treatment decisions for elderly patients. We reviewed the outcomes of elderly patients with unresectable pancreatic cancer by using a large cohort and evaluated whether they had received chemotherapy and the reason why. Methods Data for 895 pancreatic cancer patients who were treated using chemotherapy or best supportive care were analyzed considering demographics, clinical stage, treatment, and outcome. Data were analyzed using the chi-square test, Student t-test, or Mann-Whitney U-test, as appropriate. Outcomes were analyzed using the Kaplan-Meier method. Differences in survival were analyzed using the log-rank test. Results The median survival time was significantly shorter in elderly patients (≥65 years) than in younger patients (<65 years) (181 vs. 263 days, P = 0.0001). The median survival time of patients treated with chemotherapy was not significantly different between the elderly and the younger group (274 days vs. 333 days, P = 0.09), and nor was that of patients choosing best supportive care (84 days vs. 78 days, P = 0.83). These results held true even when the age cut-off between younger and elder patients was increased to 70, 75, and 80 years. Elderly patients treated with chemotherapy had a significantly longer median survival time than those choosing best supportive care (274 vs. 86 days, P < 0.0001); a significantly greater proportion of elderly patients chose best supportive care compared to younger patients (47.8 vs. 25.8%, P < 0.0001). The reason for choosing best supportive care was established in 261 elderly patients (82.9%); 133 (51.0%) met the eligibility criteria for chemotherapy, but of these, 78 (58.6%) were not informed about their disease. The treatment preferences of elderly patients were not always considered; they often received only best supportive care per family members preference (N = 65, 48.8%) or because the physician based their treatment decision only on the patient’s age (N = 68, 51.1%). Conclusions Chemotherapy appears effective for elderly pancreatic cancer patients with unresectable disease, but treatment needs to be optimized to improve prognosis. |
| first_indexed | 2024-12-12T10:33:02Z |
| format | Article |
| id | doaj.art-d360a18df914413c946c0826c12050b2 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-12T10:33:02Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-d360a18df914413c946c0826c12050b22022-12-22T00:27:18ZengBMCBMC Gastroenterology1471-230X2017-05-011711710.1186/s12876-017-0623-8Efficacy of chemotherapy in elderly patients with unresectable pancreatic cancer: a multicenter review of 895 patientsTaira Kuroda0Teru Kumagi1Tomoyuki Yokota2Nobuaki Azemoto3Aki Hasebe4Hirotaka Seike5Mari Nishiyama6Nobu Inada7Naozumi Shibata8Hideki Miyata9Tomoe Kawamura10Yusuke Imai11Akiko Ueno-Toshimori12Yoshinori Tanaka13Takashi Terao14Yoshiki Imamura15Mitsuhito Koizumi16Hirofumi Yamanishi17Yoshinori Ohno18Yoichi Hiasa19on behalf of the Ehime Pancreato-Cholangiology (EPOCH) Study GroupDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineCenter for Liver-Biliary-Pancreatic Disease, Matsuyama Red Cross HospitalDepartment of Gastroenterology, Ehime Prefectural Central HospitalDepartment of Internal Medicine, Saiseikai Imabari HospitalDepartment of Gastroenterology, Uwajima Municipal HospitalDepartment of Gastroenterology, Matsuyama Municipal HospitalDepartment of Internal Medicine, Saiseikai Matsuyama HospitalDepartment of Gastroenterology, Ehime Prefectural Niihama HospitalDepartment of Gastroenterology, Ehime Prefectural Central HospitalDepartment of Gastroenterology, Ehime Prefectural Central HospitalDepartment of Gastroenterology, Ehime Prefectural Central HospitalDepartment of Gastroenterology, Ehime Prefectural Central HospitalDepartment of Gastroenterology, Matsuyama Municipal HospitalDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineDepartment of Gastroenterology, Matsuyama Municipal HospitalDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineAbstract Background The efficacy of chemotherapy for unresectable pancreatic cancer has improved. However, it is occasionally difficult to make treatment decisions for elderly patients. We reviewed the outcomes of elderly patients with unresectable pancreatic cancer by using a large cohort and evaluated whether they had received chemotherapy and the reason why. Methods Data for 895 pancreatic cancer patients who were treated using chemotherapy or best supportive care were analyzed considering demographics, clinical stage, treatment, and outcome. Data were analyzed using the chi-square test, Student t-test, or Mann-Whitney U-test, as appropriate. Outcomes were analyzed using the Kaplan-Meier method. Differences in survival were analyzed using the log-rank test. Results The median survival time was significantly shorter in elderly patients (≥65 years) than in younger patients (<65 years) (181 vs. 263 days, P = 0.0001). The median survival time of patients treated with chemotherapy was not significantly different between the elderly and the younger group (274 days vs. 333 days, P = 0.09), and nor was that of patients choosing best supportive care (84 days vs. 78 days, P = 0.83). These results held true even when the age cut-off between younger and elder patients was increased to 70, 75, and 80 years. Elderly patients treated with chemotherapy had a significantly longer median survival time than those choosing best supportive care (274 vs. 86 days, P < 0.0001); a significantly greater proportion of elderly patients chose best supportive care compared to younger patients (47.8 vs. 25.8%, P < 0.0001). The reason for choosing best supportive care was established in 261 elderly patients (82.9%); 133 (51.0%) met the eligibility criteria for chemotherapy, but of these, 78 (58.6%) were not informed about their disease. The treatment preferences of elderly patients were not always considered; they often received only best supportive care per family members preference (N = 65, 48.8%) or because the physician based their treatment decision only on the patient’s age (N = 68, 51.1%). Conclusions Chemotherapy appears effective for elderly pancreatic cancer patients with unresectable disease, but treatment needs to be optimized to improve prognosis.http://link.springer.com/article/10.1186/s12876-017-0623-8Pancreatic cancerElderlyChemotherapyBest supportive care |
| spellingShingle | Taira Kuroda Teru Kumagi Tomoyuki Yokota Nobuaki Azemoto Aki Hasebe Hirotaka Seike Mari Nishiyama Nobu Inada Naozumi Shibata Hideki Miyata Tomoe Kawamura Yusuke Imai Akiko Ueno-Toshimori Yoshinori Tanaka Takashi Terao Yoshiki Imamura Mitsuhito Koizumi Hirofumi Yamanishi Yoshinori Ohno Yoichi Hiasa on behalf of the Ehime Pancreato-Cholangiology (EPOCH) Study Group Efficacy of chemotherapy in elderly patients with unresectable pancreatic cancer: a multicenter review of 895 patients BMC Gastroenterology Pancreatic cancer Elderly Chemotherapy Best supportive care |
| title | Efficacy of chemotherapy in elderly patients with unresectable pancreatic cancer: a multicenter review of 895 patients |
| title_full | Efficacy of chemotherapy in elderly patients with unresectable pancreatic cancer: a multicenter review of 895 patients |
| title_fullStr | Efficacy of chemotherapy in elderly patients with unresectable pancreatic cancer: a multicenter review of 895 patients |
| title_full_unstemmed | Efficacy of chemotherapy in elderly patients with unresectable pancreatic cancer: a multicenter review of 895 patients |
| title_short | Efficacy of chemotherapy in elderly patients with unresectable pancreatic cancer: a multicenter review of 895 patients |
| title_sort | efficacy of chemotherapy in elderly patients with unresectable pancreatic cancer a multicenter review of 895 patients |
| topic | Pancreatic cancer Elderly Chemotherapy Best supportive care |
| url | http://link.springer.com/article/10.1186/s12876-017-0623-8 |
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