Evidence for treatment and survival disparities by age in pancreatic adenocarcinoma: A population-based analysis

Sunil Amin, Aimee L. Lucas, Harold Frucht

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Objective: Studies demonstrate safety and survival benefits of surgical resection in older individuals with pancreatic adenocarcinoma. We investigated treatment disparities by age. METHODS: The Surveillance, Epidemiology, and End Results database for survival and treatment of pancreatic adenocarcinoma between 1983 and 2007 stratified by age: younger than 50 years, between 50 and 70 years, or older than 70 years. Kaplan-Meier curves and Cox proportional hazards models were used for survival differences, and logistic regression models were used for treatment disparities and the decision to refuse surgery. RESULTS: A total of 45,509 patients had microscopically confirmed pancreatic adenocarcinoma. Of these, 7374 (16%) received surgery and 9842 (22%) received radiation. Younger patients were more likely to receive both surgery and radiation. The prevalence of surgery decreased from 21% for those younger than 50 years to 19% for those between 50 and 70 years to 13% for those older than 70 years (P < 0.001). Radiation decreased from 28% to 25% to 17% (P < 0.001). Overall survival decreased with increasing age at diagnosis, 10.4 months (age <50 years) to 9.1 months (age 50-70 years) to 6.4 months (age >70 years) controlling for stage, sex, race, radiation, and surgery (P < 0.001). Increasing age negatively predicted the odds of receiving both surgery and radiation and increased the likelihood of refusing surgery. CONCLUSIONS: Treatment disparities exist by age despite advances in radiation and surgical treatment. Increased treatment in the elderly will increase overall survival from pancreatic adenocarcinoma.

Original languageEnglish
Pages (from-to)249-253
Number of pages5
JournalPancreas
Volume42
Issue number2
DOIs
StatePublished - Mar 2013

Keywords

  • Epidemiology and End Results)
  • SEER (Surveillance
  • age
  • disparities
  • epidemiology
  • geriatrics
  • pancreatic adenocarcinoma

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