The treatment and survival of elderly patients with locally advanced pancreatic cancer: A post-hoc analysis of a multicenter registry.

Background: The treatment options for patients with locally advanced pancreatic cancer (LAPC) have improved in recent years and consequently survival has increased. It is unknown, however, if elderly patients benefit from these improvements in therapy. With the ongoing aging of the patient population and an increasing incidence of pancreatic cancer, this patient group becomes more relevant. This study aims to clarify the association between increasing age, treatment and overall survival in patients with LAPC.
Methods: Post-hoc analysis of a multicenter registry including consecutive patients with LAPC, who were registered in 14 centers of the Dutch Pancreatic Cancer Group (April 2015-December 2017). Patients were divided in three groups according to age (<65, 65-74 and ≥75 years). Primary outcome was overall survival stratified by primary treatment strategy. Multivariable regression analyses were performed to adjust for possible confounders.
Results: Overall, 422 patients with LAPC were included; 162 patients (38%) aged <65 years, 182 patients (43%) aged 65-74 and 78 patients (19%) aged ≥75 years. Chemotherapy was administered in 86%, 81% and 50% of the patients in the different age groups (p<0.01). Median overall survival was 12, 11 and 7 months for the different age groups (p<0.01).Patients treated with chemotherapy showed comparable median overall survival of 13, 14 and 10 months for the different age groups (p=0.11). When adjusted for confounders, age was not associated with overall survival.
Conclusion: Elderly patients are less likely to be treated with chemotherapy, but when treated with chemotherapy, their survival is comparable to younger patients.
Competing Interests: Declaration of competing interest The authors have no financial interests in relation to the work. Outside the work JdVG reports grants and non-financial support from Servier; IdH reports grants from Roche Pharmaceutical, QPS/RanD, and Medtronic; VEdM reports grants from Stichting Louise Vehmeijer and NWO and travel grants from Astellas, and from Neovii; JWdG has received personal fees from Bristol-Myers Squibb, Roche, Pierre-Fabre, Servier, MSD, Novartis; MRM reports grants, personal fees and non-financial support from Angiodynamics, grants and personal fees from Medtronic Covidien, and non-financial support from Cascination; JWW reports research grants from Servier, Halozyme, Novartis, Celgene, Astra Zeneca, Pfizer, Roche, Amgen, Merck and a consulting/advisory role for Servier and Celgene; NHM reports advisory board fees for her institution from BMS, Eli Lilly, Servier, and MSD; HCvS, MGB and IQM have received research grants from the Dutch Cancer Society. For all other authors, there are no conflicts of interest.
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