Outcomes of adjuvant radiotherapy and lymph node resection in elderly patients with pancreatic cancer treated with surgery and chemotherapy

Jessica Frakes, Eric A. Mellon, Gregory M. Springett, Pamela Hodul, Mokenge P. Malafa, William J. Fulp, Xiuhua Zhao, Sarah E. Hoffe, Ravi Shridhar, Kenneth L. Meredith

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: We sought to determine the effects of post-operative radiation therapy (PORT) and lymph node resection (LNR) on survival in patients ≥70 years with pancreatic cancer treated with surgery and chemotherapy. Methods: An analysis of patients ≥70 years with surgically resected pancreatic cancer who received chemotherapy from the SEER database between 2004-2008 was performed to determine association of PORT and LNR on survival. Results: We identified 961 patients who met inclusion criteria. There was a trend towards increased survival associated with PORT in all patients (P=0.052) and N1 patients (P=0.060) but no benefit in N0 patients (P=0.161). There was no difference in OS based on number of lymph nodes removed in all (P=0.741), N0 (P=0.588), and N1 (P=0.070) patients. MVA for all patients revealed that higher T stage, N1, and high grade tumors were prognostic for increased mortality, while there was decreased mortality with PORT and mild benefit with increased lymph nodes resected (P=0.084). Conclusions: PORT demonstrated no benefit in survival of pancreatic cancer patients ≥70 who are resected and treated with adjuvant chemotherapy. Future investigation will need to address age as a stratification factor for pancreatic cancer in the adjuvant setting.

Original languageEnglish (US)
Pages (from-to)758-765
Number of pages8
JournalJournal of Gastrointestinal Oncology
Volume8
Issue number5
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

Keywords

  • Adjuvant radiation
  • Lymph node harvest
  • Outcomes in the elderly population
  • Pancreatic cancer

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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