title: Management of pancreatic cancer in the elderly.
abstract: Currently, pancreatic adenocarcinoma mainly occurs after 60 years of age, and its prognosis remains poor despite modest improvements in recent decades. The aging of the population will result in a rise in the incidence of pancreatic adenocarcinoma within the next years. Thus, the management of pancreatic cancer in the elderly population is gaining increasing relevance. Older cancer patients represent a heterogeneous group with different biological, functional and psychosocial characteristics that can modify the usual management of this disease, including pharmacokinetic and pharmacodynamic changes, polypharmacy, performance status, comorbidities and organ dysfunction. However, the biological age, not the chronological age, of the patient should be the limiting factor in determining the most appropriate treatment for these patients. Unfortunately, despite the increased incidence of this pathology in older patients, there is an underrepresentation of these patients in clinical trials, and the management of older patients is thus determined by extrapolation from the results of studies performed in younger patients. In this review, the special characteristics of the elderly, the multidisciplinary management of localized and advanced ductal adenocarcinoma of the pancreas and the most recent advances in the management of this condition will be discussed, focusing on surgery, chemotherapy, radiation and palliative care.
authors.affiliation: Oliver Higuera, Ismael Ghanem, Jaime Feliu, Department of Medical Oncology, La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: Oliver
authors.initials: O
authors.lastname: Higuera
authors.affiliation: Oliver Higuera, Ismael Ghanem, Jaime Feliu, Department of Medical Oncology, La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: Ismael
authors.initials: I
authors.lastname: Ghanem
authors.affiliation: Oliver Higuera, Ismael Ghanem, Jaime Feliu, Department of Medical Oncology, La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: Rula
authors.initials: R
authors.lastname: Nasimi
authors.affiliation: Oliver Higuera, Ismael Ghanem, Jaime Feliu, Department of Medical Oncology, La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Prieto
authors.affiliation: Oliver Higuera, Ismael Ghanem, Jaime Feliu, Department of Medical Oncology, La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Koren
authors.affiliation: Oliver Higuera, Ismael Ghanem, Jaime Feliu, Department of Medical Oncology, La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Feliu
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015577:Geriatric Assessment; D006801:Humans; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018579:Patient Selection; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Elderly; Management; Pancreatic cancer; Pancreatic ductal adenocarcinoma; Treatment
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