Horgan Anne, Knox Jennifer, Aneja Priya, Le Lisa, McKeever Elizabeth, McNamara Mairead
Princess Margaret Cancer Centre, Department of Medical Oncology, Toronto, ON, Canada.
Present address: University Hospital Waterford, Department of Medical Oncology, Ardkeen, Waterford, Ireland.
Oncotarget. 2015 Dec 29;6(42):44995-5004. doi: 10.18632/oncotarget.5707.
Although biliary tract cancers (BTC) are common in older age-groups, treatment approaches and outcomes are understudied in this population.
Data from 913 patients diagnosed with BTC from January 1987 to July 2013 and treated at Princess Margaret Cancer Center, Toronto were analyzed. The differences in treatment patterns between older and younger patients were explored and the impact of age, patient and disease characteristics on survival outcomes was assessed.
Three hundred and twenty one patients ≥ 70 years were identified. Older patients were more likely to receive best supportive care, 40% (n = 130), compared to younger patients 26% (n = 154); p < 0.0001. On multivariable analysis, factors associated with receipt of surgery included stage I/II disease (p < 0.0001) and ECOG PS < 2 (p < 0.0001). Older age was not associated with lack of surgical intervention. In comparison, older age was associated with non-receipt of palliative chemotherapy (p = 0.0007). Similar survival benefit from treatment was seen in older and younger patients. Of 626 patients that underwent either surgery or palliative chemotherapy (n = 188), the median survival was 21.1 months (95% CI 19.0-27.9) in patients >70 years of age, and 21.1 months in younger patients (n = 438) (95% CI 19.5-24.5).
In this large retrospective analysis, older patients with BTC are less likely to undergo an intervention. However, active therapy when given is associated with similar survival benefits, irrespective of age.
尽管胆道癌（BTC）在老年人群中很常见，但该人群的治疗方法和治疗结果尚未得到充分研究。
分析了1987年1月至2013年7月在多伦多玛格丽特公主癌症中心诊断为BTC并接受治疗的913例患者的数据。探讨了老年患者和年轻患者治疗模式的差异，并评估了年龄、患者和疾病特征对生存结果的影响。
确定了321例年龄≥70岁的患者。老年患者更有可能接受最佳支持治疗，比例为40%（n = 130），而年轻患者为26%（n = 154）；p < 0.0001。多变量分析显示，与接受手术相关的因素包括I/II期疾病（p < 0.0001）和东部肿瘤协作组（ECOG）体能状态评分<2（p < 0.0001）。年龄较大与未进行手术干预无关。相比之下，年龄较大与未接受姑息化疗相关（p = 0.0007）。老年患者和年轻患者从治疗中获得的生存益处相似。在626例接受手术或姑息化疗的患者中（n = 188），年龄>70岁患者的中位生存期为21.1个月（95%置信区间19.0 - 27.9），年轻患者（n = 438）为21.1个月（95%置信区间19.5 - 24.5）。
在这项大型回顾性分析中，老年BTC患者接受干预的可能性较小。然而，无论年龄大小，积极治疗均与相似的生存益处相关。
