Impact of Comorbidity and Age on Determinants Therapeutic Strategies in Advanced Pancreatic Head Cancer Patients With Obstructive Jaundices
| Autor: | Yeu-Chin Chen, Ping-Ying Chang, Ching-Liang Ho, Tzu-Chuan Huang, Ming-Shen Dai, Hsueh-Hsing Pan, Jia-Hong Chen, Yi-Ying Wu, Yu-Guang Chen, Chin Lin, Sui-Lung Su, Chieh-Sheng Lu |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Oncology medicine.medical_specialty Observational Study Comorbidity Risk Factors Internal medicine medicine Overall survival Humans In patient Intensive care medicine Survival rate Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Proportional hazards model Age Factors Retrospective cohort study General Medicine Middle Aged Prognosis medicine.disease Pancreatic Neoplasms Survival Rate Jaundice Obstructive Treatment Outcome ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Female Obstructive jaundice business Pancreatic head cancer Research Article |
| Zdroj: | Medicine |
| ISSN: | 0025-7974 |
| Popis: | Supplemental Digital Content is available in the text The current retrospective study aimed to investigate the relationship between prognostic factors and overall survival (OS) in patients with advanced pancreatic head cancers who initially presented with obstructive jaundice. Furthermore, the impact of age and comorbidities on therapeutic strategies in such patients was evaluated. A total of 79 advanced pancreatic head cancer patients who were treated at our institution between January 2006 and November 2013 were reviewed. We analyzed OS risk factors including sex, age, laboratory characteristics, Eastern Cooperative Oncology Group performance status, Charlson Comorbidity Index Scores (CCIS), and therapeutic strategies using Cox proportional hazards regression models. There was no difference in the OS of patients according to the type biliary drainage procedure they underwent. Other related factors, such as better performance status, lower CCIS, and receiving chemotherapy significantly correlated with survival in multivariate analyses. There was a significant survival benefit in systemic chemotherapy compared to best supportive care (BSC) or local radiotherapy. However, no survival benefit was found in elderly patients (age >70 years) undergoing systemic therapy compared to younger patients, except in those elderly patients with CCIS ≤ 1. In advanced pancreatic head cancer patients with obstructive jaundice, systemic therapy and adequate biliary drainage were still the most effective procedures for improving OS in the general population. However, in elderly patients with relatively higher CCIS, BSC with adequate biliary drainage was palliative and no less effective than systemic/local therapies. |
| Databáze: | OpenAIRE |
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