Adjuvant chemoradiation in pancreatic cancer: A pooled analysis in elderly (≥75 years) patients

Gian Carlo Mattiucci, Massimo Falconi, Ruud G P M Van Stiphout, Sergio Alfieri, Felipe A. Calvo, Joseph M. Herman, Bert W. Maidment, Robert C. Miller, William F. Regine, Michele Reni, Navesh Sharma, Stefano Partelli, Domenico Genovesi, Mario Balducci, Francesco Deodato, Vincenzo Valentini, Alessio G. Morganti

Research output: Contribution to journalArticle

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Abstract

Aim: To determine the impact of postoperative chemoradiation (POCR) on overall survival (OS) after resection of pancreatic adenocarcinoma (PAC) in elderly (≥75 years) patients. Materials and Methods: A multi-center retrospective review of 1248 patients who underwent complete resection with macroscopically negative margins (R0-1) for invasive PAC was performed. Exclusion criteria included age <75 years, metastatic or unresectable disease at surgery, macroscopic residual disease (R2), treatment with intraoperative radiotherapy (IORT) and postoperative death. Results: A total of 98 patients were included in the analysis (males=39.8%, females=60.2%; R1 resections=33.7%; pN1=61.2%); 63 patients received POCR and 26 patients received adjuvant chemotherapy alone. The median follow-up was 25.6 months. The mean age for the entire cohort of patients was 78.1±2.9 (SD) years. No differences were observed between patients receiving or not receiving POCR in terms of age (p=0.081), tumor diameter (p=0.412), rate of R1 resection (p=0.331) and incidence of lymph node-positive disease (p=0.078). The only factor predicting an improved OS was POCR. The median OS was 69.0 months in patients treated by POCR and 23.0 months in patients treated without POCR (p=0.008). Even by Cox multivariate analysis, the only significant predictor of OS was POCR (hazard ratio=0.449; 95% confidence interval=0.212-0.950; p=0.036). Conclusion: The study represents the first comparative approach on POCR in elderly patients after resection of PAC. OS was higher in patients who received POCR. Further analyses are warranted to evaluate the toxicity rate/grade and the impact of POCR on patient quality of life.

Original languageEnglish (US)
Pages (from-to)3441-3446
Number of pages6
JournalAnticancer Research
Volume35
Issue number6
StatePublished - Jun 1 2015

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Pancreatic Neoplasms
Survival
Adenocarcinoma
Adjuvant Chemotherapy
Radiotherapy
Multivariate Analysis
Lymph Nodes
Quality of Life
Confidence Intervals

Keywords

  • Adjuvant
  • Aged
  • Chemotherapy
  • Multicenter study
  • Pancreatic cancer
  • Pooled analysis
  • Radiotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Mattiucci, G. C., Falconi, M., Van Stiphout, R. G. P. M., Alfieri, S., Calvo, F. A., Herman, J. M., ... Morganti, A. G. (2015). Adjuvant chemoradiation in pancreatic cancer: A pooled analysis in elderly (≥75 years) patients. Anticancer Research, 35(6), 3441-3446.

Adjuvant chemoradiation in pancreatic cancer : A pooled analysis in elderly (≥75 years) patients. / Mattiucci, Gian Carlo; Falconi, Massimo; Van Stiphout, Ruud G P M; Alfieri, Sergio; Calvo, Felipe A.; Herman, Joseph M.; Maidment, Bert W.; Miller, Robert C.; Regine, William F.; Reni, Michele; Sharma, Navesh; Partelli, Stefano; Genovesi, Domenico; Balducci, Mario; Deodato, Francesco; Valentini, Vincenzo; Morganti, Alessio G.

In: Anticancer Research, Vol. 35, No. 6, 01.06.2015, p. 3441-3446.

Research output: Contribution to journalArticle

Mattiucci, GC, Falconi, M, Van Stiphout, RGPM, Alfieri, S, Calvo, FA, Herman, JM, Maidment, BW, Miller, RC, Regine, WF, Reni, M, Sharma, N, Partelli, S, Genovesi, D, Balducci, M, Deodato, F, Valentini, V & Morganti, AG 2015, 'Adjuvant chemoradiation in pancreatic cancer: A pooled analysis in elderly (≥75 years) patients', Anticancer Research, vol. 35, no. 6, pp. 3441-3446.
Mattiucci GC, Falconi M, Van Stiphout RGPM, Alfieri S, Calvo FA, Herman JM et al. Adjuvant chemoradiation in pancreatic cancer: A pooled analysis in elderly (≥75 years) patients. Anticancer Research. 2015 Jun 1;35(6):3441-3446.
Mattiucci, Gian Carlo ; Falconi, Massimo ; Van Stiphout, Ruud G P M ; Alfieri, Sergio ; Calvo, Felipe A. ; Herman, Joseph M. ; Maidment, Bert W. ; Miller, Robert C. ; Regine, William F. ; Reni, Michele ; Sharma, Navesh ; Partelli, Stefano ; Genovesi, Domenico ; Balducci, Mario ; Deodato, Francesco ; Valentini, Vincenzo ; Morganti, Alessio G. / Adjuvant chemoradiation in pancreatic cancer : A pooled analysis in elderly (≥75 years) patients. In: Anticancer Research. 2015 ; Vol. 35, No. 6. pp. 3441-3446.
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abstract = "Aim: To determine the impact of postoperative chemoradiation (POCR) on overall survival (OS) after resection of pancreatic adenocarcinoma (PAC) in elderly (≥75 years) patients. Materials and Methods: A multi-center retrospective review of 1248 patients who underwent complete resection with macroscopically negative margins (R0-1) for invasive PAC was performed. Exclusion criteria included age <75 years, metastatic or unresectable disease at surgery, macroscopic residual disease (R2), treatment with intraoperative radiotherapy (IORT) and postoperative death. Results: A total of 98 patients were included in the analysis (males=39.8{\%}, females=60.2{\%}; R1 resections=33.7{\%}; pN1=61.2{\%}); 63 patients received POCR and 26 patients received adjuvant chemotherapy alone. The median follow-up was 25.6 months. The mean age for the entire cohort of patients was 78.1±2.9 (SD) years. No differences were observed between patients receiving or not receiving POCR in terms of age (p=0.081), tumor diameter (p=0.412), rate of R1 resection (p=0.331) and incidence of lymph node-positive disease (p=0.078). The only factor predicting an improved OS was POCR. The median OS was 69.0 months in patients treated by POCR and 23.0 months in patients treated without POCR (p=0.008). Even by Cox multivariate analysis, the only significant predictor of OS was POCR (hazard ratio=0.449; 95{\%} confidence interval=0.212-0.950; p=0.036). Conclusion: The study represents the first comparative approach on POCR in elderly patients after resection of PAC. OS was higher in patients who received POCR. Further analyses are warranted to evaluate the toxicity rate/grade and the impact of POCR on patient quality of life.",
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T1 - Adjuvant chemoradiation in pancreatic cancer

T2 - A pooled analysis in elderly (≥75 years) patients

AU - Mattiucci, Gian Carlo

AU - Falconi, Massimo

AU - Van Stiphout, Ruud G P M

AU - Alfieri, Sergio

AU - Calvo, Felipe A.

AU - Herman, Joseph M.

AU - Maidment, Bert W.

AU - Miller, Robert C.

AU - Regine, William F.

AU - Reni, Michele

AU - Sharma, Navesh

AU - Partelli, Stefano

AU - Genovesi, Domenico

AU - Balducci, Mario

AU - Deodato, Francesco

AU - Valentini, Vincenzo

AU - Morganti, Alessio G.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Aim: To determine the impact of postoperative chemoradiation (POCR) on overall survival (OS) after resection of pancreatic adenocarcinoma (PAC) in elderly (≥75 years) patients. Materials and Methods: A multi-center retrospective review of 1248 patients who underwent complete resection with macroscopically negative margins (R0-1) for invasive PAC was performed. Exclusion criteria included age <75 years, metastatic or unresectable disease at surgery, macroscopic residual disease (R2), treatment with intraoperative radiotherapy (IORT) and postoperative death. Results: A total of 98 patients were included in the analysis (males=39.8%, females=60.2%; R1 resections=33.7%; pN1=61.2%); 63 patients received POCR and 26 patients received adjuvant chemotherapy alone. The median follow-up was 25.6 months. The mean age for the entire cohort of patients was 78.1±2.9 (SD) years. No differences were observed between patients receiving or not receiving POCR in terms of age (p=0.081), tumor diameter (p=0.412), rate of R1 resection (p=0.331) and incidence of lymph node-positive disease (p=0.078). The only factor predicting an improved OS was POCR. The median OS was 69.0 months in patients treated by POCR and 23.0 months in patients treated without POCR (p=0.008). Even by Cox multivariate analysis, the only significant predictor of OS was POCR (hazard ratio=0.449; 95% confidence interval=0.212-0.950; p=0.036). Conclusion: The study represents the first comparative approach on POCR in elderly patients after resection of PAC. OS was higher in patients who received POCR. Further analyses are warranted to evaluate the toxicity rate/grade and the impact of POCR on patient quality of life.

AB - Aim: To determine the impact of postoperative chemoradiation (POCR) on overall survival (OS) after resection of pancreatic adenocarcinoma (PAC) in elderly (≥75 years) patients. Materials and Methods: A multi-center retrospective review of 1248 patients who underwent complete resection with macroscopically negative margins (R0-1) for invasive PAC was performed. Exclusion criteria included age <75 years, metastatic or unresectable disease at surgery, macroscopic residual disease (R2), treatment with intraoperative radiotherapy (IORT) and postoperative death. Results: A total of 98 patients were included in the analysis (males=39.8%, females=60.2%; R1 resections=33.7%; pN1=61.2%); 63 patients received POCR and 26 patients received adjuvant chemotherapy alone. The median follow-up was 25.6 months. The mean age for the entire cohort of patients was 78.1±2.9 (SD) years. No differences were observed between patients receiving or not receiving POCR in terms of age (p=0.081), tumor diameter (p=0.412), rate of R1 resection (p=0.331) and incidence of lymph node-positive disease (p=0.078). The only factor predicting an improved OS was POCR. The median OS was 69.0 months in patients treated by POCR and 23.0 months in patients treated without POCR (p=0.008). Even by Cox multivariate analysis, the only significant predictor of OS was POCR (hazard ratio=0.449; 95% confidence interval=0.212-0.950; p=0.036). Conclusion: The study represents the first comparative approach on POCR in elderly patients after resection of PAC. OS was higher in patients who received POCR. Further analyses are warranted to evaluate the toxicity rate/grade and the impact of POCR on patient quality of life.

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KW - Aged

KW - Chemotherapy

KW - Multicenter study

KW - Pancreatic cancer

KW - Pooled analysis

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