Comorbidity, not age, is prognostic in patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy

Nakai, Yousuke; Isayama, Hiroyuki; Sasaki, Takashi; Sasahira, Naoki; Tsujino, Takeshi; Kogure, Hirofumi; Yagioka, Hiroshi; Yashima, Yoko; Togawa, Osama; Arizumi, Toshihiko; Matsubara, Saburo; Hirano, Kenji; Tada, Minoru; Omata, Masao; Koike, Kazuhiko

doi:10.1016/j.critrevonc.2010.05.007

« Previous Next »Critical Reviews in Oncology / Hematology
Volume 78, Issue 3 , Pages 252-259, June 2011

Comorbidity, not age, is prognostic in patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy

Yousuke Nakai
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Hiroyuki Isayama
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
- Corresponding author at: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan. Tel.: +81 3 3815 5411; fax: +81 3 3814 0021.
Takashi Sasaki
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Naoki Sasahira
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Takeshi Tsujino
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Hirofumi Kogure
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Hiroshi Yagioka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Yoko Yashima
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Osama Togawa
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Toshihiko Arizumi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Saburo Matsubara
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Kenji Hirano
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Minoru Tada
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
Masao Omata
- Yamanashi Prefectural Hospital Organization, Japan
Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan

Accepted 28 May 2010. published online 25 June 2010.

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.

Keywords: Age, Comorbidity, Chemotherapy, Pancreatic cancer, Gemcitabine