Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands.
Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands.
Acta Oncol. 2022 Mar;61(3):286-293. doi: 10.1080/0284186X.2021.2016949. Epub 2021 Dec 22.
The diagnosis of pancreatic ductal adenocarcinoma (PDAC) has an enormous impact on patients, and even more so if they are of younger age. It is unclear how their treatment and outcome compare to older patients. This study compares clinicopathological characteristics and overall survival (OS) of PDAC patients aged <60 years to older PDAC patients.
This is a retrospective, population-based cohort study using Netherlands Cancer Registry data of patients diagnosed with PDAC (1 January 2015-31 December 2018). Kaplan-Meier curves and Cox proportional hazards models were used to assess OS.
Overall, 10,298 patients were included, of whom 1551 (15%) were <60 years. Patients <60 years were more often male, had better performance status, less comorbidities and less stage I disease, and more often received anticancer treatment (67 33%, < 0.001) than older patients. Patients <60 years underwent resection of the tumour more often (22 14% < 0.001), more often received chemotherapy, and had a better median OS (6.9 3.3 months, < 0.001) compared to older patients. No differences in median OS were demonstrated between both age groups of patients who underwent resection (19.7 19.4 months, = 0.123), received chemotherapy alone (7.8 8.5 months, = 0.191), or received no anticancer treatment (1.8 1.9 months, = 0.600). Patients <60 years with stage-IV disease receiving chemotherapy had a somewhat better OS (7.5 6.3 months, = 0.026).
Patients with PDAC <60 years more often underwent resection despite less stage I disease and had superior OS. Stratified for treatment, however, survival was largely similar.
胰腺导管腺癌（PDAC）的诊断对患者有巨大影响，如果患者年龄较轻则影响更大。目前尚不清楚他们的治疗和预后与老年患者相比如何。本研究比较了年龄<60 岁的 PDAC 患者与年龄较大的 PDAC 患者的临床病理特征和总生存期（OS）。
这是一项使用荷兰癌症登记处 2015 年 1 月 1 日至 2018 年 12 月 31 日期间诊断为 PDAC 的患者的回顾性、基于人群的队列研究。使用 Kaplan-Meier 曲线和 Cox 比例风险模型评估 OS。
共纳入 10298 例患者，其中 1551 例（15%）年龄<60 岁。与老年患者相比，<60 岁的患者更常为男性，一般状态更好，合并症更少，I 期疾病更少，更常接受抗癌治疗（67% vs. 33%，<0.001）。<60 岁的患者更常接受肿瘤切除术（22% vs. 14%，<0.001），更常接受化疗，中位 OS 更好（6.9 vs. 3.3 个月，<0.001）。在接受切除术的两组患者中，中位 OS 无差异（19.7 vs. 19.4 个月，=0.123），接受单纯化疗的患者（7.8 vs. 8.5 个月，=0.191），或未接受抗癌治疗的患者（1.8 vs. 1.9 个月，=0.600）。接受化疗的 IV 期疾病<60 岁的患者 OS 略好（7.5 vs. 6.3 个月，=0.026）。
尽管 I 期疾病较少，<60 岁的 PDAC 患者更常接受切除术，OS 更好。然而，分层治疗后，生存情况基本相似。
