Surgery: The Fundamental Part of Treatment in Elderly Esophageal Squamous Cell Carcinoma Patients.

Objectives: Non-metastatic esophageal squamous cell carcinoma (ESCC) patients are treated with neoadjuvant chemoradiotherapy (CRT) followed by surgery. Older patients may have treatment-related toxicity at higher rates. We presented our experience regarding CRT followed by surgery on survival in older ESCC patients. Methods: Older ESCC patients diagnosed between 2009-2021 were included. Overall survival (OS) estimates were calculated by Kaplan-Meier analyses and compared by Log-rank tests. Effects of ECOG performance status and age groups on survival were also presented. Results: A total of 66 older ESCC patients were included. The median duration of follow-up was 62.3 months. The median OS of patients who were treated with surgery was significantly higher than those who were treated with CRT alone (48+, CI 95%: - vs. 14.1 months, CI 95%: 9.3-18.8, respectively, p=0.005). The median OS of patients who underwent surgery was significantly higher after adjusting by ECOG performance status and age groups than those who were treated with CRT alone (adjusted p=0.008 for ECOG and adjusted p=0.011 for age groups at diagnosis). Conclusion: Surgery after CRT improves survival in older ESCC patients compared to CRT alone. Therefore, surgery should not be avoided in older patients solely due to patient age. [ABSTRACT FROM AUTHOR]