Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2020; 8(18): 4022-4033
Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4022
First-line chemotherapy in very elderly patients with metastatic pancreatic cancer: Gemcitabine monotherapy vs combination chemotherapy
Sung Yong Han, Dong Uk Kim, Young Mi Seol, Suk Kim, Nam Kyung Lee, Seung Baek Hong, Hyung-Il Seo
Sung Yong Han, Dong Uk Kim, Department of Internal Medicine and Biomedical Research Institute, Division of Gastroenterology, Pusan National University Hospital, Busan 49241, South Korea
Young Mi Seol, Department of Internal Medicine and Biomedical Research Institute, Division of Hematology-Oncology, Pusan National University Hospital, Busan 49241, South Korea
Suk Kim, Nam Kyung Lee, Seung Baek Hong, Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Hyung-Il Seo, Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Author contributions: Seol YM designed the research; Han SY, Lee NK, and Hong SB performed research; Han SY and Seo HI contributed to data analysis; Han SY wrote the paper; Kim DU and Kim S contributed to the critical revision of the paper.
Supported by The National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT), No. 2018R1C1B5086234.
Institutional review board statement: The study protocol was approved by the Institutional Review Board of the Pusan National University (IRB No. H-2005-019-091).
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Young Mi Seol, MD, PhD, Assistant Professor, Department of Internal Medicine and Biomedical Research Institute, Division of Hematology-Oncology, Pusan National University Hospital, Gudeok ro 179, Seo-gu, Busan 49241, South Korea. seol2100@hanmail.net
Received: May 27, 2020
Peer-review started: May 27, 2020
First decision: June 13, 2020
Revised: June 18, 2020
Accepted: August 22, 2020
Article in press: August 22, 2020
Published online: September 26, 2020
Processing time: 117 Days and 3.3 Hours
ARTICLE HIGHLIGHTS
Research background

In very elderly (age 75 and over) pancreatic cancer patients, it is not well known which chemotherapy regimens are more effective.

Research motivation

It is hypothesized that a chemotherapy regimen that has low adverse event rates may be more effective in very elderly patients.

Research objectives

In this study, the authors aimed to determine which chemotherapy regimen is more efficacious in very elderly pancreatic cancer patients.

Research methods

The authors performed analysis after propensity-score matching to compare the patients who received combination or gemcitabine monotherapy chemotherapy.

Research results

In very elderly patients, there was no significant difference in progression-free survival and overall survival between the gemcitabine monotherapy and combination chemotherapy groups.

Research conclusions

Gemcitabine monotherapy may be a better option to manage metastatic pancreatic cancer in very elderly patients.

Research perspectives

In very elderly patients, chemotherapy regimens have similar efficacy, so it seems reasonable to use gemcitabine treatment in terms of adverse effects.