Kadokura Makoto, Mori Yuki, Takenaka Yumi, Yoda Hiroki, Yasumura Tomoki, Tanaka Keisuke, Amemiya Fumitake
Department of Gastroenterology, Kofu Municipal Hospital, Kofu, Japan.
JMA J. 2022 Oct 17;5(4):512-519. doi: 10.31662/jmaj.2022-0086. Epub 2022 Sep 20.
The usefulness of various prognostic factors for advanced pancreatic cancer (APC) has been reported, but the number of elderly patients in these studies is disproportionately fewer than those in general practice. This study aimed to examine the prognostic factors for elderly patients with APC receiving gemcitabine plus nab-paclitaxel (GnP) considering the G8 geriatric assessment tool.
We retrospectively analyzed 77 elderly (≥65 years old) patients with APC who received GnP as first-line chemotherapy at our hospital. We used the receiver operating characteristic curve to set the optimal cutoff value for G8. Univariate and multivariate Cox regression models were applied to study independent prognostic factors.
The progression-free survival was 5.5 months, and the overall survival (OS) was 12.0 months in all patients. The most optimal cutoff of G8 was 10.5. OS of G8 ≥10.5 patients was superior to that of G8 <10.5 patients (18.5 versus 8.0 months). Multivariate analysis showed that Eastern Cooperative Oncology Group performance status 1 (hazard ratio [HR] 3.00, p = 0.02), neutrophil-lymphocyte ratio ≥3.9 (HR 2.73, p = 0.03), and G8 geriatric assessment <10.5 (HR 5.38, p < 0.001) were independent negative prognostic factors.
G8 is useful for predicting prognoses in elderly patients with APC receiving GnP.
已有报道多种预后因素对晚期胰腺癌（APC）的作用，但这些研究中老年患者的数量比一般临床实践中的患者数量少得多。本研究旨在考虑G8老年评估工具，探讨接受吉西他滨联合白蛋白结合型紫杉醇（GnP）治疗的老年APC患者的预后因素。
我们回顾性分析了我院77例接受GnP作为一线化疗的老年（≥65岁）APC患者。我们使用受试者工作特征曲线来设定G8的最佳临界值。应用单因素和多因素Cox回归模型研究独立预后因素。
所有患者的无进展生存期为5.5个月，总生存期（OS）为12.0个月。G8的最佳临界值为10.5。G8≥10.5患者的OS优于G8<10.5患者（18.5个月对8.0个月）。多因素分析显示，东部肿瘤协作组体能状态评分为1（风险比[HR] 3.00，p = 0.02）、中性粒细胞与淋巴细胞比值≥3.9（HR 2.73，p = 0.03）以及G8老年评估<10.5（HR 5.38，p < 0.001）是独立的不良预后因素。
G8有助于预测接受GnP治疗的老年APC患者的预后。
