Adjuvant Chemoradiotherapy in the Management of Resectable Pancreatic Cancer in the Elderly: Analysis Using a National Database  

Michael McLeod, MD, MBA, FACS    

Principal Invistigator: Michael McLeod, MD, MBA, FACS, Department of Surgery, College of Human Medicine , Michigan State University (MSU)

A research team composed of two residents and three faculty members of The Department of Surgery investigate the survival outcome of elderly pancreatic cancer patients who have undergone a combination of chemotherapy and radiation therapy following pancreatic resection.

Pancreatic cancers only constitute 2.2% of cancers in the United States but are this country’s 4th leading cause of cancer-related death. The majority of patients present at stages not amenable to surgery alone and subsequently require adjuvant forms of therapy after resection. Unfortunately, the use of chemo-radiotherapy as a treatment modality has been fraught with controversies as the studies aimed at investigating its role have yielded varying results. These trials also focus on predominantly younger demographics. The results of these trials have been extrapolated to apply to the treatment of elderly patients. However, this population has physiologic, pharmacologic and performance statuses that are very different from the younger population. There is a paucity of robust research data that specifically studies this treatment modality in the rising demographic of elderly patients.

This project proposed will be a retrospective review of the Surveillance, Epidemiology, and End Results (SEER) - Medicare Database an extensive national database with comprehensive clinical and demographic information about elderly persons with cancer. The project is geared toward analyzing and comparing the survival outcomes of pancreatic cancer patients 65 years and older. Those who received a combination of chemotherapy and radiotherapy after surgical resection of pancreatic cancer will be compared with those who were treated with surgery alone and those treated with surgery and either chemotherapy or radiotherapy. This study is unique because it is one of the few to focus on pancreatic cancer care in the elderly population which has become an area of increasing interest. Furthermore, it will be the first investigation to analyze the survival benefits of chemo-radiotherapy using this robust and multicenter database. The project will therefore play a major part in contributing to the improved management of pancreatic cancer in the elderly, providing information that will shed light on the benefits and details of different treatment modalities and hopefully helping to end the treatment controversies caused by lack of data.

These results will contribute not only to the quality of patient care at Sparrow Hospital and its oncologic center, but also to the ongoing national dialogue aimed at improving pancreatic cancer treatment in the most susceptible population – the elderly.

The project team consists of two principal investigators: Dr. Michael McLeod and Dr. Tolulope Oyasiji. Dr. McLeod is a renowned endocrine surgeon with vast clinical and research experience. His practice is based out of Sparrow Hospital and he is currently a professor with the Michigan State University Department of Surgery. Dr. Oyasiji is a surgical oncologist with an in-depth experience in oncologic research. He is currently an attending surgical oncologist at the Barbara Ann Karmanos Cancer Institute at McLaren Flint and an assistant professor with Michigan State University. The Sub-investigators, Chibueze Onyemkpa and Danielle Dougherty, are both second year residents in good standing in the Michigan State University Department of Surgery. Statistical analysis will be done by Dr. Alan Davis who is currently the Director of Research at the Grand Rapids Medical Education partners and an associate professor with the Michigan State University Department of Surgery.