The effect of surgery plus chemoradiotherapy on survival of elderly patients with stage Ⅱ–Ⅲ esophageal cancer: a SEER‐based demographic analysis

Abstract Background The optimal treatment for elderly patients with esophageal cancer (EC) remains controversial. In the present study, we aimed to investigate whether elderly patients with stage II–III EC could benefit from trimodal therapy. Methods The selected elderly patients with stage II–III E...

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Autores principales: Hao Lv, Ce Chao, Bin Wang, Zhigang Wang, Yongxiang Qian, Xiaoying Zhang
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Publicado: Wiley 2021
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spelling oai:doaj.org-article:686a6aef4bb745e5af50e2b0ec6ef86a2021-12-01T04:49:15ZThe effect of surgery plus chemoradiotherapy on survival of elderly patients with stage Ⅱ–Ⅲ esophageal cancer: a SEER‐based demographic analysis2045-763410.1002/cam4.4352https://doaj.org/article/686a6aef4bb745e5af50e2b0ec6ef86a2021-12-01T00:00:00Zhttps://doi.org/10.1002/cam4.4352https://doaj.org/toc/2045-7634Abstract Background The optimal treatment for elderly patients with esophageal cancer (EC) remains controversial. In the present study, we aimed to investigate whether elderly patients with stage II–III EC could benefit from trimodal therapy. Methods The selected elderly patients with stage II–III EC between 2004 and 2015 were included in a retrospective cohort study from the Surveillance, Epidemiology, and End Results database. The patients were divided into two groups based on whether or not they underwent surgery. The inverse probability of treatment weighting (IPTW) analysis was used to balance the confounding factors between the two groups. The Cox regression analysis, the log‐rank test, and the Kaplan–Meier curves were conducted to identify the survival benefits of different treatment regimes. Results A total of 1596 patients were included in this cohort study, in which 278 patients underwent surgery. In the combination of chemoradiotherapy and surgery group, there were more male patients, more patients aged between 75 and 79 years, and more married patients in the surgery group. Moreover, there were more patients with adenomatous carcinoma, more patients with a tumor size of less than 5 cm, and more patients with a T3 stage in the combination group. In the survival analysis, patients in the combination group had a longer overall survival (OS) and EC‐specific survival (ECSS). After IPTW analysis, the survival analysis generated similar results. The competitive risk model found that our results were stable. There was still a significant difference in OS and ECSS between the combination group and chemoradiotherapy alone group for esophageal adenocarcinoma (p < 0.001). Conclusions Elderly patients with stage II–III EC, especially those with adenocarcinoma, could benefit from the combination of surgery and chemoradiotherapy.Hao LvCe ChaoBin WangZhigang WangYongxiang QianXiaoying ZhangWileyarticlechemoradiotherapyelderly patientsesophageal cancersurgerysurvivalNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Medicine, Vol 10, Iss 23, Pp 8483-8496 (2021)
institution DOAJ
collection DOAJ
language EN
topic chemoradiotherapy
elderly patients
esophageal cancer
surgery
survival
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
spellingShingle chemoradiotherapy
elderly patients
esophageal cancer
surgery
survival
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Hao Lv
Ce Chao
Bin Wang
Zhigang Wang
Yongxiang Qian
Xiaoying Zhang
The effect of surgery plus chemoradiotherapy on survival of elderly patients with stage Ⅱ–Ⅲ esophageal cancer: a SEER‐based demographic analysis
description Abstract Background The optimal treatment for elderly patients with esophageal cancer (EC) remains controversial. In the present study, we aimed to investigate whether elderly patients with stage II–III EC could benefit from trimodal therapy. Methods The selected elderly patients with stage II–III EC between 2004 and 2015 were included in a retrospective cohort study from the Surveillance, Epidemiology, and End Results database. The patients were divided into two groups based on whether or not they underwent surgery. The inverse probability of treatment weighting (IPTW) analysis was used to balance the confounding factors between the two groups. The Cox regression analysis, the log‐rank test, and the Kaplan–Meier curves were conducted to identify the survival benefits of different treatment regimes. Results A total of 1596 patients were included in this cohort study, in which 278 patients underwent surgery. In the combination of chemoradiotherapy and surgery group, there were more male patients, more patients aged between 75 and 79 years, and more married patients in the surgery group. Moreover, there were more patients with adenomatous carcinoma, more patients with a tumor size of less than 5 cm, and more patients with a T3 stage in the combination group. In the survival analysis, patients in the combination group had a longer overall survival (OS) and EC‐specific survival (ECSS). After IPTW analysis, the survival analysis generated similar results. The competitive risk model found that our results were stable. There was still a significant difference in OS and ECSS between the combination group and chemoradiotherapy alone group for esophageal adenocarcinoma (p < 0.001). Conclusions Elderly patients with stage II–III EC, especially those with adenocarcinoma, could benefit from the combination of surgery and chemoradiotherapy.
format article
author Hao Lv
Ce Chao
Bin Wang
Zhigang Wang
Yongxiang Qian
Xiaoying Zhang
author_facet Hao Lv
Ce Chao
Bin Wang
Zhigang Wang
Yongxiang Qian
Xiaoying Zhang
author_sort Hao Lv
title The effect of surgery plus chemoradiotherapy on survival of elderly patients with stage Ⅱ–Ⅲ esophageal cancer: a SEER‐based demographic analysis
title_short The effect of surgery plus chemoradiotherapy on survival of elderly patients with stage Ⅱ–Ⅲ esophageal cancer: a SEER‐based demographic analysis
title_full The effect of surgery plus chemoradiotherapy on survival of elderly patients with stage Ⅱ–Ⅲ esophageal cancer: a SEER‐based demographic analysis
title_fullStr The effect of surgery plus chemoradiotherapy on survival of elderly patients with stage Ⅱ–Ⅲ esophageal cancer: a SEER‐based demographic analysis
title_full_unstemmed The effect of surgery plus chemoradiotherapy on survival of elderly patients with stage Ⅱ–Ⅲ esophageal cancer: a SEER‐based demographic analysis
title_sort effect of surgery plus chemoradiotherapy on survival of elderly patients with stage ⅱ–ⅲ esophageal cancer: a seer‐based demographic analysis
publisher Wiley
publishDate 2021
url https://doaj.org/article/686a6aef4bb745e5af50e2b0ec6ef86a
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