Comorbidity, not age, is prognostic in patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy.
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.
Nakai
Yousuke
Y
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan.
Isayama
Hiroyuki
H
Sasaki
Takashi
T
Sasahira
Naoki
N
Tsujino
Takeshi
T
Kogure
Hirofumi
H
Yagioka
Hiroshi
H
Yashima
Yoko
Y
Togawa
Osama
O
Arizumi
Toshihiko
T
Matsubara
Saburo
S
Hirano
Kenji
K
Tada
Minoru
M
Omata
Masao
M
Koike
Kazuhiko
K
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015897:Comorbidity; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D011379:Prognosis; D016019:Survival Analysis; D000093542:Gemcitabine
D003841:Deoxycytidine; D000093542:Gemcitabine