title: Comorbidity, not age, is prognostic in patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan.
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Sasahira
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsujino
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kogure
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagioka
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yashima
authors.forename: Osama
authors.initials: O
authors.lastname: Togawa
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Arizumi
authors.forename: Saburo
authors.initials: S
authors.lastname: Matsubara
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirano
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: 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
chemical_list: D003841:Deoxycytidine; D000093542:Gemcitabine