System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Epublish

PubMed: 42795364 DOI: 10.3390/life16091499

Young Age Is Associated with Improved Survival After Resection of Non-Metastatic Pancreatic Ductal Adenocarcinoma.

Life (Basel) 16(9)

Authors: Ingrid Garajová, Bing Wang, Inna Markovna Chen, Carsten Palnæs Hansen, Annalisa Comandatore, Nina Fokter Dovnik, Radim Nemecek, Michal Eid, Marko Hojnik, Damjan Sisinger, Tomaž Rojko, Fabio Gelsomino, Stefania De Lorenzo, Geert Kazemier, Luca Morelli, Elisa Giovannetti

Affiliations

  • Medical Oncology Unit, University Hospital of Parma, 43125 Parma, Italy.
  • Laboratory Medical Oncology, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
  • Department of Oncology, Copenhagen University Hospital-Herlev and Gentofte Hospital, 2730 Copenhagen, Denmark.
  • Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark.
  • General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
  • Department of Medical Oncology, University Medical Centre Maribor, 2000 Maribor, Slovenia.
  • Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, 65653 Brno, Czech Republic.
  • Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic.
  • Department of Pathology, University Medical Centre Maribor, 2000 Maribor, Slovenia.
  • Department of Oncology and Hematology, University Hospital of Modena, 41124 Modena, Italy.
  • Oncology Unit, Azienda USL Bologna, 40124 Bologna, Italy.
  • Department of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
  • Cancer Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.
  • Cancer Pharmacology Laboratory, AIRC Start-Up Unit, Fondazione Pisana per la Scienza, 56126 Pisa, Italy.

Abstract

In pancreatic ductal adenocarcinoma (PDAC), clinicians often ask whether young age is associated with more aggressive disease or patients more likely to tolerate curative-intent multimodality treatment. The prognostic meaning of age after surgery remains uncertain. We analyzed a retrospective multicenter surgical cohort of patients with resected non-metastatic PDAC. Candidate clinical variables were evaluated in univariable Cox models. The prespecified primary multivariable model included age, sex, N status, T stage, and CA19-9 status. Adjuvant therapy was evaluated in a sensitivity model. The cohort included 696 surgical patients; 70 (10.1%) were aged < 55 years. Median overall survival was 34.4 months in patients aged < 55 years versus 22.0 months in those aged ≥ 55 years (log-rank p = 0.019). In the primary multivariable model, age < 55 years remained independently favorable (HR 0.66, 95% CI 0.49-0.89; p = 0.007). Elevated CA19-9 value independently predicted worse survival (HR 1.39, 95% CI 1.13-1.71; p = 0.002). The sensitivity model confirmed favorable associations for young age and not elevated CA19-9 value. In surgically managed PDAC patients, young age and normal CA19-9 value carried independent favorable prognostic information. Prognosis was also shaped by nodal status, T stage, and receipt of adjuvant therapy.

MeSH

Adenocarcinoma, Aged, Therapeutics, Prognosis