Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis

Abstract Background Esophageal cancer (EC) is a common and lethal carcinoma; however, the effectiveness and feasibility of the chemo- and radio-therapy (CRT) for the elderly patients (≥ 70 years) with surgery have not been fully discussed. The purpose of this study was to investigate the potential e...

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Autores principales:	Xinrong Li, Jin Zhang, Chenxiao Ye, Junquan Zhu, Kaibo Guo, Yong Guo
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Elderly patient Esophageal cancer Nomogram Predictive model Cancer-specific death Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/e8fc57102dee46d29b42babbf1d98351
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spelling	oai:doaj.org-article:e8fc57102dee46d29b42babbf1d983512021-11-21T12:15:36ZImpact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis10.1186/s12876-021-02016-91471-230Xhttps://doaj.org/article/e8fc57102dee46d29b42babbf1d983512021-11-01T00:00:00Zhttps://doi.org/10.1186/s12876-021-02016-9https://doaj.org/toc/1471-230XAbstract Background Esophageal cancer (EC) is a common and lethal carcinoma; however, the effectiveness and feasibility of the chemo- and radio-therapy (CRT) for the elderly patients (≥ 70 years) with surgery have not been fully discussed. The purpose of this study was to investigate the potential effect of CRT on the prognosis. Methods A total of 1085 patients (534 CRT patients vs. 551 non-CRT patients) from 1998 to 2016 were collected from the Surveillance, Epidemiology, and End Results database according to the inclusion and exclusion criteria. Using the competing risk regression and survival analysis, an overall estimation of the effectiveness of CRT was performed on a well-balanced cohort via performing propensity score matching. Then, the specific impact of CRT on high- (n = 557) and low-risk (n = 528) cohorts derived from the nomogram’s risk quantification for every patient were further evaluated respectively. Additionally, the advantages of the nomogram model and the conventional tumor, node, metastasis (TNM, 6th revision) staging system were compared. Results A better survival outcome was observed among patients receiving both surgery and CRT than those who underwent surgery alone (HR: 0.55, 95% CI 0.45–0.68, P < 0.001), especially for those with tumors characterized by poor differentiation, large tumor size, advanced T staging, lymphatic metastasis, and distant metastasis (HR: 0.48, 95% CI 0.39–0.59, P < 0.001), while no benefit was observed among the low-risk patients. Furthermore, the newly established nomogram model might be better than the TNM (6th revision) staging system but more data needed. Conclusion Aggressive treatments, such as surgery, chemotherapy, and radiotherapy, were considered effective for selected elderly patients with EC according to the newly established nomogram model.Xinrong LiJin ZhangChenxiao YeJunquan ZhuKaibo GuoYong GuoBMCarticleElderly patientEsophageal cancerNomogramPredictive modelCancer-specific deathDiseases of the digestive system. GastroenterologyRC799-869ENBMC Gastroenterology, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Elderly patient Esophageal cancer Nomogram Predictive model Cancer-specific death Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Elderly patient Esophageal cancer Nomogram Predictive model Cancer-specific death Diseases of the digestive system. Gastroenterology RC799-869 Xinrong Li Jin Zhang Chenxiao Ye Junquan Zhu Kaibo Guo Yong Guo Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis
description	Abstract Background Esophageal cancer (EC) is a common and lethal carcinoma; however, the effectiveness and feasibility of the chemo- and radio-therapy (CRT) for the elderly patients (≥ 70 years) with surgery have not been fully discussed. The purpose of this study was to investigate the potential effect of CRT on the prognosis. Methods A total of 1085 patients (534 CRT patients vs. 551 non-CRT patients) from 1998 to 2016 were collected from the Surveillance, Epidemiology, and End Results database according to the inclusion and exclusion criteria. Using the competing risk regression and survival analysis, an overall estimation of the effectiveness of CRT was performed on a well-balanced cohort via performing propensity score matching. Then, the specific impact of CRT on high- (n = 557) and low-risk (n = 528) cohorts derived from the nomogram’s risk quantification for every patient were further evaluated respectively. Additionally, the advantages of the nomogram model and the conventional tumor, node, metastasis (TNM, 6th revision) staging system were compared. Results A better survival outcome was observed among patients receiving both surgery and CRT than those who underwent surgery alone (HR: 0.55, 95% CI 0.45–0.68, P < 0.001), especially for those with tumors characterized by poor differentiation, large tumor size, advanced T staging, lymphatic metastasis, and distant metastasis (HR: 0.48, 95% CI 0.39–0.59, P < 0.001), while no benefit was observed among the low-risk patients. Furthermore, the newly established nomogram model might be better than the TNM (6th revision) staging system but more data needed. Conclusion Aggressive treatments, such as surgery, chemotherapy, and radiotherapy, were considered effective for selected elderly patients with EC according to the newly established nomogram model.
format	article
author	Xinrong Li Jin Zhang Chenxiao Ye Junquan Zhu Kaibo Guo Yong Guo
author_facet	Xinrong Li Jin Zhang Chenxiao Ye Junquan Zhu Kaibo Guo Yong Guo
author_sort	Xinrong Li
title	Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis
title_short	Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis
title_full	Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis
title_fullStr	Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis
title_full_unstemmed	Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis
title_sort	impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a seer database analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e8fc57102dee46d29b42babbf1d98351
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Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis

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