Introduction

Although older adults aged ≥75 years comprise a substantial proportion of patients diagnosed with pancreatic cancer (PC), the effectiveness of chemotherapy in older adults with PC remains to be established.

Materials and Methods

This retrospective study examined the effectiveness of chemotherapy according to age in older adult patients with metastatic PC. We used a large database that combined three data sources (the hospital-based cancer registry database, Osaka Cancer Registry, and Japan's Diagnosis Procedure Combination) and extracted data from patients pathologically diagnosed with metastatic PC between 2013 and 2015 in 31 designated cancer care hospitals in Japan. Propensity score matching (PSM) was used to identify a cohort of patients with similar backgrounds. The effect of chemotherapy on overall survival (OS) was analyzed using the log-rank test.

Results

Compared with 687 younger patients (<75 years old), 276 older adult patients had significant impairments in activities of daily living and poorer prognoses (6.8 vs. 4.1 months, p < 0.001), with a lower frequency of chemotherapy (81.5% vs. 55.1%; p < 0.001). PSM of older adult patients showed that chemotherapy significantly contributed to a better prognosis (best supportive care, 2.6 months vs. chemotherapy, 5.8 months, p < 0.001). Age group analysis with PSM of five-year age ranges revealed that the median OS was significantly longer in the chemotherapy group among older adult patients aged <85 years.

Discussion

Chemotherapy provides a survival benefit in older adult patients with metastatic PC, and patients aged <85 years could be promising candidates for chemotherapy.

中文翻译：

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老年转移性胰腺癌患者的化疗效果和年龄组分析：一项日本癌症登记队列研究

介绍

尽管年龄≥75 岁的老年人在诊断为胰腺癌 (PC) 的患者中占很大比例，但化疗对患有 PC 的老年人的有效性仍有待确定。

材料和方法

这项回顾性研究根据年龄对老年转移性 PC 患者进行化疗的有效性进行了检查。我们使用了一个结合了三个数据源（基于医院的癌症登记数据库、大阪癌症登记和日本诊断程序组合）的大型数据库，并提取了 2013 年至 2015 年间在日本 31 家指定癌症护理医院病理诊断为转移性 PC 的患者的数据。日本。倾向得分匹配 (PSM) 用于识别具有相似背景的一组患者。使用对数秩检验分析化疗对总生存期 (OS) 的影响。

结果

与 687 名年轻患者（<75 岁）相比，276 名老年患者的日常生活能力明显受损且预后较差（6.8 个月对 4.1 个月，p  < 0.001），化疗频率较低（81.5% 对55.1%；p  < 0.001）。老年患者的 PSM 显示化疗显着有助于改善预后（最佳支持治疗，2.6 个月与化疗，5.8 个月，p  < 0.001）。使用 5 岁年龄范围的 PSM 进行的年龄组分析显示，在年龄 <85 岁的老年患者中，化疗组的中位 OS 明显更长。

讨论

化疗为患有转移性 PC 的老年成人患者提供了生存获益，年龄 <85 岁的患者可能是化疗的有希望的候选人。