Survival outcome of esophagectomy and chemoradiotherapy for resectable esophageal squamous cell carcinoma in patients >75 years of age.

IF 2.3 3区医学 Q3 ONCOLOGY

Thoracic Cancer Pub Date : 2024-07-01 Epub Date: 2024-06-19 DOI:10.1111/1759-7714.15329

Shuhei Mayanagi, Masazumi Inoue, Kazunori Tokizawa, Kunihiro Fushiki, Takahiro Tsushima, Tomoya Yokota, Kentaro Yamazaki, Hirofumi Yasui, Yasuhiro Tsubosa

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引用次数: 0

Abstract

Background: The gold standard for resectable, locally advanced esophageal squamous cell carcinoma (ESCC) is surgery-based treatment; however, it is unclear whether esophagectomy or chemoradiotherapy is suitable for older patients. This retrospective study aimed to identify the treatment outcomes of surgery-based therapy versus definitive chemoradiotherapy (dCRT) as an initial treatment for older patients with resectable, locally advanced ESCC.

Methods: Data from 434 patients who received radical treatment for resectable, locally advanced ESCC were collected from January 2011 to December 2020. Of the patients >75 years of age, 49 underwent radical esophagectomy and 26 received dCRT. Survival was compared between the surgery and dCRT groups.

Results: The mean ages of the surgery and chemoradiotherapy groups were 77.3 and 78.8 years, respectively. Differences in overall survival (OS) between the two groups were not statistically significant (3-year OS: surgery 66.2%, dCRT 55.7%, p = 0.236). Multivariate analysis for OS showed a hazard ratio of 1.229 for dCRT versus surgery (90% confidence interval 0.681-2.217). OS did not differ between the groups in any of the performance statuses. For patients who were able to receive chemotherapy using fluorouracil and cisplatin, OS tended to be better in the surgery group, but the difference was not statistically significant (3-year OS: surgery 68.1%, dCRT 51.8%, p = 0.117).

Conclusions: There was no clear difference in survival outcome between surgery-based therapy and dCRT as an initial treatment for esophageal cancer in older patients. Either treatment may be an option for older patients.

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对年龄大于 75 岁的可切除食管鳞状细胞癌患者进行食管切除术和放化疗的生存效果。

背景：可切除的局部晚期食管鳞状细胞癌（ESCC）的金标准是手术治疗，但食管切除术或化学放疗是否适合老年患者尚不清楚。这项回顾性研究旨在确定手术治疗与确定性化放疗（dCRT）作为可切除的局部晚期ESCC老年患者初始治疗方法的治疗效果：收集了2011年1月至2020年12月期间434名接受根治性治疗的可切除局部晚期ESCC患者的数据。在年龄大于 75 岁的患者中，49 人接受了根治性食管切除术，26 人接受了 dCRT。比较了手术组和 dCRT 组的生存率：手术组和化疗组的平均年龄分别为 77.3 岁和 78.8 岁。两组的总生存率（OS）差异无统计学意义（3年OS：手术66.2%，dCRT 55.7%，P = 0.236）。OS多变量分析显示，dCRT与手术的危险比为1.229（90%置信区间为0.681-2.217）。各组间的 OS 在任何表现状态下均无差异。对于能够接受氟尿嘧啶和顺铂化疗的患者，手术组的OS往往更好，但差异无统计学意义（3年OS：手术68.1%，dCRT 51.8%，P = 0.117）：结论：在老年食管癌的初始治疗中，手术治疗和 dCRT 治疗的生存结果没有明显差异。老年患者可以选择两种治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.