論文種別	原著(症例報告除く)
言語種別	英語
査読の有無	その他(不明)
表題	Neoadjuvant and adjuvant treatment for pancreatic ductal adenocarcinoma in patients over 80 years old based on a nationwide clinical database.
掲載誌名	正式名：Journal of gastroenterology 略　 称：J Gastroenterol ISSNコード：14355922/09441174
掲載区分	国外
巻・号・頁	pp.Online ahead of print
著者・共著者	Daisuke Hashimoto, Shinya Hirakawa, Masamichi Mizuma, Hisateru Tachimori, So Yamaki, Takao Itoi, Shinichi Egawa, Yuzo Kodama, Kohei Nakata, Shin Hamada, Ichiro Yasuda, Michiaki Unno, Yoshihiro Kakeji, Ken Shirabe, Sohei Satoi, Atsushi Masamune, Yoshifumi Takeyama
発行年月	2026/07
概要	BACKGROUND:The proportion of elderly patients with pancreatic ductal adenocarcinoma (PDAC) is increasing. This study aimed to investigate whether neoadjuvant treatment (NAT) and adjuvant therapy (AT) are effective in PDAC patients over 80 years of age.METHODS:Patients over 80 years of age who underwent pancreatectomy for PDAC in 2012-2020 and were recorded in the Japan Society for Gastroenterological Surgery and Japan Pancreas Society databases were included. Propensity score matching (PSM) analysis was performed to determine whether NAT and AT contribute to survival. In patients treated from 2017 onward, resectability status was incorporated into the PSM model.RESULTS:Of the 3438 patients in the study population, the primary resectability-adjusted PSM analysis of NAT among patients treated from 2017 onward compared 274 matched pairs. The MST was 30.5 (95% CI, 26.2-NA) and 29.0 (95% CI, 22.3-38.0) months in the NAT and non-NAT groups, respectively, with no significant difference (p = 0.205 [stratified log-rank]). In a complementary full-cohort PSM analysis, 393 matched pairs were compared; the MST was 32.9 and 30.2 months, respectively, with no significant difference. In a PSM-matched comparison of 1213 patients who received AT versus 1213 patients who did not, MST was longer in the former (30.7 [95% CI, 27.3-33.2] versus 23.7 [95% CI, 21.8-26.1] months, p < 0.001 [stratified log-rank]).CONCLUSION:NAT did not show a statistically significant survival benefit in PDAC patients aged 80 years or older, however, this finding should be interpreted with caution. In contrast, AT was associated with improved survival.
DOI	10.1007/s00535-026-02480-8
PMID	42463583