Prognostic Value of Adjuvant Chemotherapy Following Pancreaticoduodenectomy in Elderly Patients With Pancreatic Cancer

Anticancer Res. 2019 Feb;39(2):1005-1012. doi: 10.21873/anticanres.13206.

Abstract

Background/aim: The aim of this study was to investigate the relationship between age and long-term survival among patients who underwent pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC).

Patients and methods: A total of 916 patients who underwent PD for curative resection of PDAC were included in this study. Patients were divided into younger (n=726, <70 years) and older (n=190, ≥70 years), and the overall survival (OS) between the two groups was compared.

Results: Median OS was significantly longer in the younger group (p<0.001). However, the survival advantage among younger patients was not significant when analyzing only patients who received adjuvant chemotherapy (p=0.548). Among patients who did not receive adjuvant chemotherapy, OS was significantly longer in the younger group (p=0.003). Among patients who received neither adjuvant chemotherapy nor treatment for recurrence, survival was not significantly different between the groups (p=0.629).

Conclusion: Adjuvant chemotherapy should be recommended, and additional treatment for recurrence is effective even among elderly who have not received adjuvant chemotherapy.

Keywords: Pancreatic cancer; adjuvant; elderly chemotherapy; pancreaticoduodenectomy.

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / surgery*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical
  • Carcinoma, Pancreatic Ductal / drug therapy*
  • Carcinoma, Pancreatic Ductal / surgery*
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome