Esophageal cancer in elderly patients: a population-based study

Yuan Zeng; Wenhua Liang; Jun Liu; Jiaxi He; Calvin S H Ng; Chia-Chuan Liu; René Horsleben Petersen; Gaetano Rocco; Thomas D'Amico; Alessandro Brunelli; Haiquan Chen; Xiuyi Zhi; Xiao Dong; Wei Wang; Fei Cui; Dakai Xiao; Wenjun Wang; Wei Yang; Hui Pan; Jianxing He; written on behalf of the AME Thoracic Surgery Collaborative Group

doi:10.21037/jtd.2018.01.89

Esophageal cancer in elderly patients: a population-based study

Yuan Zeng, Wenhua Liang, Jun Liu, Jiaxi He, Calvin S H Ng, Chia-Chuan Liu, René Horsleben Petersen, Gaetano Rocco, Thomas D'Amico, Alessandro Brunelli, Haiquan Chen, Xiuyi Zhi, Xiao Dong, Wei Wang, Fei Cui, Dakai Xiao, Wenjun Wang, Wei Yang, Hui Pan, Jianxing Hewritten on behalf of the AME Thoracic Surgery Collaborative Group

Institut for Klinisk Medicin

10 Citationer (Scopus)

Abstract

Background: As the aging issue and increased elderly esophageal cancer (EC) patients, we sought to study the clinical characteristics, treatment modality and outcomes of EC patients 70 years or older compared with those younger than 70 years old.

Methods: The national surveillance, epidemiology, and end results (SEER) database for the period from 1973 to 2013 was analyzed. The patient and treatment characteristics were compared between the age groups. Multivariate Cox proportional hazard regression analyses were also performed to identify independent prognostic factors. Propensity-score matching analyses (PSA) regarding survival after different treatments were also performed in locoregional EC.

Results: Compared with the younger group, patients 70 years or older were characterized by having a higher proportion of patients with female gender, white race, localized disease, non-adenocarcinoma and without any treatment, as well as inferior overall survival (OS) [hazard ratio (HR), 1.324] and EC-specific survival (HR, 1.270). In addition, older patients shared same independent prognostic factors with younger patients, including age, histology and race. Specifically, compared with those receiving no intensive treatments, surgery alone (HR, 0.342), both surgery and RT (HR, 0.323) and RT only (HR, 0.525) were favorable among elderly patients, as confirmed by both multivariate adjustment and PSA.

Conclusions: Compared to younger EC patients, those 70 years or older showed distinctive clinical characteristics and inferior survival. Despite showing a higher proportion of localized disease, patients 70 years or older were less likely to be subjected to surgery or/and RT. Thus, the role of intensive treatments, which were identified as favorable factors among elderly patients in this study, warrants further investigation.

Originalsprog	Engelsk
Tidsskrift	Journal of Thoracic Disease
Vol/bind	10
Udgave nummer	1
Sider (fra-til)	448-457
Antal sider	10
ISSN	2072-1439
DOI	https://doi.org/10.21037/jtd.2018.01.89
Status	Udgivet - 1 jan. 2018

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10.21037/jtd.2018.01.89

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Zeng, Y., Liang, W., Liu, J., He, J., Ng, C. S. H., Liu, C.-C., Petersen, R. H., Rocco, G., D'Amico, T., Brunelli, A., Chen, H., Zhi, X., Dong, X., Wang, W., Cui, F., Xiao, D., Wang, W., Yang, W., Pan, H., ... written on behalf of the AME Thoracic Surgery Collaborative Group (2018). Esophageal cancer in elderly patients: a population-based study. Journal of Thoracic Disease, 10(1), 448-457. https://doi.org/10.21037/jtd.2018.01.89

Zeng, Y, Liang, W, Liu, J, He, J, Ng, CSH, Liu, C-C, Petersen, RH, Rocco, G, D'Amico, T, Brunelli, A, Chen, H, Zhi, X, Dong, X, Wang, W, Cui, F, Xiao, D, Wang, W, Yang, W, Pan, H, He, J & written on behalf of the AME Thoracic Surgery Collaborative Group 2018, 'Esophageal cancer in elderly patients: a population-based study', Journal of Thoracic Disease, bind 10, nr. 1, s. 448-457. https://doi.org/10.21037/jtd.2018.01.89

@article{ed4ce3985a1e4df4b877e3333bcfdb73,

title = "Esophageal cancer in elderly patients: a population-based study",

abstract = "Background: As the aging issue and increased elderly esophageal cancer (EC) patients, we sought to study the clinical characteristics, treatment modality and outcomes of EC patients 70 years or older compared with those younger than 70 years old.Methods: The national surveillance, epidemiology, and end results (SEER) database for the period from 1973 to 2013 was analyzed. The patient and treatment characteristics were compared between the age groups. Multivariate Cox proportional hazard regression analyses were also performed to identify independent prognostic factors. Propensity-score matching analyses (PSA) regarding survival after different treatments were also performed in locoregional EC.Results: Compared with the younger group, patients 70 years or older were characterized by having a higher proportion of patients with female gender, white race, localized disease, non-adenocarcinoma and without any treatment, as well as inferior overall survival (OS) [hazard ratio (HR), 1.324] and EC-specific survival (HR, 1.270). In addition, older patients shared same independent prognostic factors with younger patients, including age, histology and race. Specifically, compared with those receiving no intensive treatments, surgery alone (HR, 0.342), both surgery and RT (HR, 0.323) and RT only (HR, 0.525) were favorable among elderly patients, as confirmed by both multivariate adjustment and PSA.Conclusions: Compared to younger EC patients, those 70 years or older showed distinctive clinical characteristics and inferior survival. Despite showing a higher proportion of localized disease, patients 70 years or older were less likely to be subjected to surgery or/and RT. Thus, the role of intensive treatments, which were identified as favorable factors among elderly patients in this study, warrants further investigation.",

author = "Yuan Zeng and Wenhua Liang and Jun Liu and Jiaxi He and Ng, {Calvin S H} and Chia-Chuan Liu and Petersen, {Ren{\'e} Horsleben} and Gaetano Rocco and Thomas D'Amico and Alessandro Brunelli and Haiquan Chen and Xiuyi Zhi and Xiao Dong and Wei Wang and Fei Cui and Dakai Xiao and Wenjun Wang and Wei Yang and Hui Pan and Jianxing He and {written on behalf of the AME Thoracic Surgery Collaborative Group}",

year = "2018",

month = jan,

day = "1",

doi = "10.21037/jtd.2018.01.89",

language = "English",

volume = "10",

pages = "448--457",

journal = "Journal of Thoracic Disease",

issn = "2072-1439",

publisher = "Pioneer Bioscience Publishing Company",

number = "1",

}

TY - JOUR

T1 - Esophageal cancer in elderly patients

T2 - a population-based study

AU - Zeng, Yuan

AU - Liang, Wenhua

AU - Liu, Jun

AU - He, Jiaxi

AU - Ng, Calvin S H

AU - Liu, Chia-Chuan

AU - Petersen, René Horsleben

AU - Rocco, Gaetano

AU - D'Amico, Thomas

AU - Brunelli, Alessandro

AU - Chen, Haiquan

AU - Zhi, Xiuyi

AU - Dong, Xiao

AU - Wang, Wei

AU - Cui, Fei

AU - Xiao, Dakai

AU - Wang, Wenjun

AU - Yang, Wei

AU - Pan, Hui

AU - He, Jianxing

AU - written on behalf of the AME Thoracic Surgery Collaborative Group

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: As the aging issue and increased elderly esophageal cancer (EC) patients, we sought to study the clinical characteristics, treatment modality and outcomes of EC patients 70 years or older compared with those younger than 70 years old.Methods: The national surveillance, epidemiology, and end results (SEER) database for the period from 1973 to 2013 was analyzed. The patient and treatment characteristics were compared between the age groups. Multivariate Cox proportional hazard regression analyses were also performed to identify independent prognostic factors. Propensity-score matching analyses (PSA) regarding survival after different treatments were also performed in locoregional EC.Results: Compared with the younger group, patients 70 years or older were characterized by having a higher proportion of patients with female gender, white race, localized disease, non-adenocarcinoma and without any treatment, as well as inferior overall survival (OS) [hazard ratio (HR), 1.324] and EC-specific survival (HR, 1.270). In addition, older patients shared same independent prognostic factors with younger patients, including age, histology and race. Specifically, compared with those receiving no intensive treatments, surgery alone (HR, 0.342), both surgery and RT (HR, 0.323) and RT only (HR, 0.525) were favorable among elderly patients, as confirmed by both multivariate adjustment and PSA.Conclusions: Compared to younger EC patients, those 70 years or older showed distinctive clinical characteristics and inferior survival. Despite showing a higher proportion of localized disease, patients 70 years or older were less likely to be subjected to surgery or/and RT. Thus, the role of intensive treatments, which were identified as favorable factors among elderly patients in this study, warrants further investigation.

AB - Background: As the aging issue and increased elderly esophageal cancer (EC) patients, we sought to study the clinical characteristics, treatment modality and outcomes of EC patients 70 years or older compared with those younger than 70 years old.Methods: The national surveillance, epidemiology, and end results (SEER) database for the period from 1973 to 2013 was analyzed. The patient and treatment characteristics were compared between the age groups. Multivariate Cox proportional hazard regression analyses were also performed to identify independent prognostic factors. Propensity-score matching analyses (PSA) regarding survival after different treatments were also performed in locoregional EC.Results: Compared with the younger group, patients 70 years or older were characterized by having a higher proportion of patients with female gender, white race, localized disease, non-adenocarcinoma and without any treatment, as well as inferior overall survival (OS) [hazard ratio (HR), 1.324] and EC-specific survival (HR, 1.270). In addition, older patients shared same independent prognostic factors with younger patients, including age, histology and race. Specifically, compared with those receiving no intensive treatments, surgery alone (HR, 0.342), both surgery and RT (HR, 0.323) and RT only (HR, 0.525) were favorable among elderly patients, as confirmed by both multivariate adjustment and PSA.Conclusions: Compared to younger EC patients, those 70 years or older showed distinctive clinical characteristics and inferior survival. Despite showing a higher proportion of localized disease, patients 70 years or older were less likely to be subjected to surgery or/and RT. Thus, the role of intensive treatments, which were identified as favorable factors among elderly patients in this study, warrants further investigation.

U2 - 10.21037/jtd.2018.01.89

DO - 10.21037/jtd.2018.01.89

M3 - Journal article

C2 - 29600077

SN - 2072-1439

VL - 10

SP - 448

EP - 457

JO - Journal of Thoracic Disease

JF - Journal of Thoracic Disease

IS - 1

ER -

Esophageal cancer in elderly patients: a population-based study

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