Comorbidity, not age, is prognostic in patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy

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• 作者：Yousuke Nakai^a ; Hiroyuki Isayama^a ; ^{isayama-2im@h.u-tokyo.ac.jp"" rel=""nofollow} ; Takashi Sasaki^a ; Naoki Sasahira^a ; Takeshi Tsujino^a ; Hirofumi Kogure^a ; Hiroshi Yagioka^a ; Yoko Yashima^a ; Osama Togawa^a ; Toshihiko Arizumi^a ; Saburo Matsubara^a ; Kenji Hirano^a ; Minoru Tada^a ; Masao Omata^b ; Kazuhiko Koike^a [Author vitae]
• 关键词：Age ; Comorbidity ; Chemotherapy ; Pancreatic cancer ; Gemcitabine
• 刊名：Critical Reviews in Oncology/Hematology
• 出版年：2011
• 出版时间：June 2011
• 年：2011
• 卷：78
• 期：3
• 页码：252-259
• 全文大小：173 K

文摘

Objective

To evaluate the impact of age and comorbidity on clinical outcomes in advanced pancreatic cancer.

Methods

Consecutive 237 patients with advanced pancreatic cancer were studied. Comorbidity was scored by Charlson comorbidity index (CCI). We compared the clinical outcomes by age or comorbidity.

Results

Sixty-nine patients were elderly (≥75 years), and CCI was 0 in 69 patients, 1 in 98, and ≥2 in 70. Gemcitabine-based chemotherapy was administered in 183 patients and was well tolerated in both elderly group and in those with comorbidities. In a multivariate analysis, CCI, not age, was prognostic in addition to PS, distant metastasis, chemotherapy and CA19-9: the hazard ratios of CCI 1 and ≥2 were 1.25 and 1.55, compared with CCI 0 (p = 0.027).

Conclusions

Gemcitabine-based chemotherapy can be an effective treatment, without significant toxicity, in elderly patients. Comorbidity, not age, was prognostic in patients with advanced pancreatic cancer.