Evolving management of early stage pancreatic adenocarcinoma in older patients.

Authors

Sean Nassoiy, Providence St. John's Cancer Institute, Santa Monica, CA, USAFollow
Wade O Christopher, Department of Surgical Oncology, Providence St John's Cancer Institute, Santa Monica, CA, USAFollow
Rebecca Marcus, Providence St. John's Cancer Institute, Santa Monica, CA, USAFollow
Jennifer Keller, Providence St. John's Cancer Institute, Santa Monica, CA, USAFollow
Jessica Weiss, Providence Saint John's Cancer Institute, Santa Monica, CA, USA.Follow
Shu-Ching Chang, Providence St. Joseph HealthFollow
Richard Essner, Providence St. Joseph HealthFollow
Lee Foshag, Department of Surgical Oncology, John Wayne Cancer Institute, Saint John's Health Center, Santa Monica, CaliforniaFollow
Trevan Fischer, John Wayne Cancer Institute, Santa Monica, California, USAFollow
Melanie Goldfarb, Providence St. John's Health Center, Santa Monica, CAFollow

Document Type

Article

Publication Date

8-19-2022

Publication Title

American journal of surgery

Keywords

california; sjci; santa monica; oregon; beaverton

Abstract

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.

Clinical Institute

Cancer

Department

Geriatrics

Department

Oncology

Recommended Citation

Nassoiy, Sean; Christopher, Wade O; Marcus, Rebecca; Keller, Jennifer; Weiss, Jessica; Chang, Shu-Ching; Essner, Richard; Foshag, Lee; Fischer, Trevan; and Goldfarb, Melanie, "Evolving management of early stage pancreatic adenocarcinoma in older patients." (2022). Articles, Abstracts, and Reports. 6513.
https://digitalcommons.providence.org/publications/6513