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Does Esophagectomy Provide a Survival Advantage to Patients Aged 80 Years or Older? Analyzing 5066 Patients in the National Database of Hospital-based Cancer Registries in Japan.
- Source :
-
Annals of surgery [Ann Surg] 2022 Jul 01; Vol. 276 (1), pp. e16-e23. Date of Electronic Publication: 2020 Dec 29. - Publication Year :
- 2022
-
Abstract
- Objective: To determine whether esophagectomy provides a survival advantage in octogenarians with resectable thoracic esophageal cancer.<br />Summary Background Data: Elderly patients with thoracic esophageal cancer do not always receive the full standard treatment; however, advanced age alone should not preclude the use of effective treatment that could meaningfully improve survival.<br />Methods: We retrieved the 2008 to 2011 data from the National Database of Hospital-based Cancer Registries from the National Cancer Centerin Japan, divided the patients into a ≥75 group (75-79 years; n = 2935) and a ≥80 group (80 years or older; n = 2131), and then compared the patient backgrounds and survival curves. A multivariable Cox proportional hazards regression model was developed to compare the effects of esophagectomy and chemoradiotherapy in the 2 groups.<br />Results: A significantly greater percentage of patients were treated with esoph-agectomy in the ≥75 group (34.6%) than the ≥80 group (18.4%). Among patients who received esophagectomy, the 3-year survival rate was 51.1% in the ≥ 75 group and 39.0% in the ≥80 group (P < 0.001). However, among patients who received chemoradiotherapy, there was no difference in survival curve between the 2 groups (P = 0.17). Multivariable Cox proportional hazard analysis revealed that esoph-agectomy for clinical Stage ii-iii patients was significantly associated to better survival (adjusted HR: 0.731) (95%CI: 0.645-0.829, P < 0.001) in the ≥75 group but not the ≥ 80 group when compared with chemoradiotherapy.<br />Conclusions: Many octogenarians do not necessarily get a survival benefit from esophagectomy. However, patients should be evaluated based on their overall health before ruling out surgery based on age alone.<br />Competing Interests: The authors report no conflicts of interest.<br /> (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc.)
Details
- Language :
- English
- ISSN :
- 1528-1140
- Volume :
- 276
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 33630469
- Full Text :
- https://doi.org/10.1097/SLA.0000000000004437