TY - JOUR
T1 - Overall Survival and Prognostic Factors among Older Patients with Metastatic Pancreatic Cancer
T2 - A Retrospective Analysis Using a Hospital Database
AU - Conti, Catherine
AU - Pamoukdjian, Frédéric
AU - Aparicio, Thomas
AU - Mebarki, Soraya
AU - Poisson, Johanne
AU - Manceau, Gilles
AU - Taieb, Julien
AU - Rance, Bastien
AU - Katsahian, Sandrine
AU - Charles-Nelson, Anaïs
AU - Paillaud, Elena
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/3
Y1 - 2022/3
N2 - Pre-therapeutic factors associated with overall survival (OS) among older patients ≥70 years with metastatic pancreatic cancer (mPC) are not known. This was a retrospective single-centre cohort study in Paris including 159 consecutive older patients with mPC between 2000 and 2018. Alongside geriatric parameters, specific comorbidities, cancer-related data and chemotherapy regimens were retrieved. Cox multivariate models were run to assess predictors for OS. The median age was 80 years, 52% were women, 21.5% had diabetes, and 48% had pancreatic head cancer and 72% liver metastases. 62% of the patients (n = 99) received chemotherapy, among which the gemcitabine + nab-paclitaxel (GnP) regimen was the most frequent (72%). Median OS [95%CI] was 7.40 [5.60–10.0] and 1.40 [0.90–2.20] months respectively for patients with and without chemotherapy. The GnP regimen (aHR [95%CI] = 0.47 [0.25–0.89], p = 0.02) and diabetes (aHR = 0.44 [0.24–0.77], p = 0.004) (or anti-diabetic therapy) were multivariate protective factors for death, while ECOG-PS, liver metastases, and the neutrophil cell count were multivariate risk factors for death. In the chemotherapy group, ECOG-PS, number of metastatic sites and the GnP remained significantly associated with OS. Our study confirms the feasibility and efficacy of chemotherapy and the protective effects of diabetes among older patients with mPC.
AB - Pre-therapeutic factors associated with overall survival (OS) among older patients ≥70 years with metastatic pancreatic cancer (mPC) are not known. This was a retrospective single-centre cohort study in Paris including 159 consecutive older patients with mPC between 2000 and 2018. Alongside geriatric parameters, specific comorbidities, cancer-related data and chemotherapy regimens were retrieved. Cox multivariate models were run to assess predictors for OS. The median age was 80 years, 52% were women, 21.5% had diabetes, and 48% had pancreatic head cancer and 72% liver metastases. 62% of the patients (n = 99) received chemotherapy, among which the gemcitabine + nab-paclitaxel (GnP) regimen was the most frequent (72%). Median OS [95%CI] was 7.40 [5.60–10.0] and 1.40 [0.90–2.20] months respectively for patients with and without chemotherapy. The GnP regimen (aHR [95%CI] = 0.47 [0.25–0.89], p = 0.02) and diabetes (aHR = 0.44 [0.24–0.77], p = 0.004) (or anti-diabetic therapy) were multivariate protective factors for death, while ECOG-PS, liver metastases, and the neutrophil cell count were multivariate risk factors for death. In the chemotherapy group, ECOG-PS, number of metastatic sites and the GnP remained significantly associated with OS. Our study confirms the feasibility and efficacy of chemotherapy and the protective effects of diabetes among older patients with mPC.
KW - Chemotherapy
KW - Diabetes
KW - Functional status
KW - Older adults
KW - Overall survival
KW - Pancreatic cancer
KW - Prognostic factors
UR - http://www.scopus.com/inward/record.url?scp=85125202501&partnerID=8YFLogxK
U2 - 10.3390/cancers14051105
DO - 10.3390/cancers14051105
M3 - Article
C2 - 35267412
AN - SCOPUS:85125202501
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 5
M1 - 1105
ER -