Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 226] Clinical Implication of Gemcitabine + S-1 Neoadjuvant Chemotherapy for Resectable Pancreatic Cancer in Elderly Patients
Shozo MORI 1, Takayuki SHIRAKI 1, Maiko NIKI 1, Shun SATO 1, Genki TANAKA 1, Takamune YAMAGUCHI 1, Kyung-Hwa PARK 1, Takatsugu MATSUMOTO 1, Yukihiro ISO 1, Taku AOKI 1
1 Department of Hepato-Biliary-Pancreatic Surgery, Dokkyo Medical University, JAPAN
Background : Neoadjuvant chemotherapy (NAC)-gemcitabine plus S-1 (GS) has been reported to have a survival benefit in patients with resectable pancreatic ductal adenocarcinoma (PDAC) (Prep-02/JSAP05). However, in the elderly patients, clinical implication of NAC-GS has not been fully evaluated.
Methods : Patients with resectable PDAC who underwent a surgery between December 2013 and March 2023 were divided into two groups: an elderly group (≥75 years) (n=90) and a non-elderly group (〈75 years) (n=182).
Results : NAC was used in 43 and 119 patients in the elderly and non-elderly groups, respectively (P=0.005). Of these, NAC-GS was used in 30 and 83 patients (P=0.398). The relative dose intensity was significantly lower in the elderly group than in the non-elderly group (77.4% vs. 91.2%, P=0.022). However, no significant differences with respect to NAC-GS completion rate (53.3% vs. 42.2%, P=0.292) and grade 3 and 4 adverse event (66.7% vs. 66.3%, P=0.968) were observed. Four and 3 patients in the elderly and non-elderly groups underwent laparotomy only. Differences between groups regarding the Clavien-Dindo ≥III complications (26.9% vs. 26.3%, P=0.946) and postoperative hospital stay (P=0.889) were not significant. There were no significant differences regarding the overall survival between the two groups (median: 15.7 months vs. 28.6 months, P=0.432). AC was used in 20 and 70 patients in the elderly and non-elderly groups, respectively (P=0.160). The grade 3 and 4 adverse event during AC was not differ between the two groups (35% vs. 24.3%, P=0.339).
Conclusions : NAC-GS can be performed safely in the elderly patients. However, careful patient selection for chemotherapy would be required.
Methods : Patients with resectable PDAC who underwent a surgery between December 2013 and March 2023 were divided into two groups: an elderly group (≥75 years) (n=90) and a non-elderly group (〈75 years) (n=182).
Results : NAC was used in 43 and 119 patients in the elderly and non-elderly groups, respectively (P=0.005). Of these, NAC-GS was used in 30 and 83 patients (P=0.398). The relative dose intensity was significantly lower in the elderly group than in the non-elderly group (77.4% vs. 91.2%, P=0.022). However, no significant differences with respect to NAC-GS completion rate (53.3% vs. 42.2%, P=0.292) and grade 3 and 4 adverse event (66.7% vs. 66.3%, P=0.968) were observed. Four and 3 patients in the elderly and non-elderly groups underwent laparotomy only. Differences between groups regarding the Clavien-Dindo ≥III complications (26.9% vs. 26.3%, P=0.946) and postoperative hospital stay (P=0.889) were not significant. There were no significant differences regarding the overall survival between the two groups (median: 15.7 months vs. 28.6 months, P=0.432). AC was used in 20 and 70 patients in the elderly and non-elderly groups, respectively (P=0.160). The grade 3 and 4 adverse event during AC was not differ between the two groups (35% vs. 24.3%, P=0.339).
Conclusions : NAC-GS can be performed safely in the elderly patients. However, careful patient selection for chemotherapy would be required.
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E-poster
E-Session 03/21 ALL DAY