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Survival benefit evaluation of radiotherapy in esophageal cancer patients aged 80 and older.

ABSTRACT: To evaluate the survival benefit of radiotherapy (RT) in esophageal cancer (EC) patients aged ? 80.Records for all EC patients aged ? 65 years were extracted from the Surveillance, Epidemiology, and End Results database. Chi-square test compared the characteristic and treatment between patients aged ? 80 with those aged 65-79. Focusing on patients aged ? 80, we employed multivariable logistic regression to identify the association between selection of RT and patients' characteristics. Survival curve was employed to visualize the survival rate and multivariable Cox proportional hazard model was established to quantify the effect of RT on overall survival (OS) and cancer special survival (CSS).Patients aged ? 80 were more likely to be white male and have localized EC (all P < 0.001). Selection of RT in patients aged ? 80 were associated with cancer histology (P < 0.001), grade (P = 0.024) and stage (P < 0.001). RT significantly improved the OS (hazard ratio(HR) = 0.717) and CSS (HR = 0.722) (all P < 0.001). Further stratified analysis found the improvement were only significant in the localized (OS HR = 0.662; CSS HR=0.652) and regional stage patients (OS HR = 0.571; CSS HR = 0.581) (all P < 0.001).Our study suggested EC patients aged ? 80 benefit from RT only if the cancer is in localized/regional stage.

SUBMITTER: Huang S

PROVIDER: S-EPMC5762382 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Survival benefit evaluation of radiotherapy in esophageal cancer patients aged 80 and older.

Huang Shan S Zheng Shuyu S Gong Tuotuo T Ma Hongbing H Ke Yue Y Zhao Songchuan S Wang Wenyu W Jia Lijun L Zhang Xiaozhi X

Oncotarget 20171204 67

<h4>Purpose</h4>To evaluate the survival benefit of radiotherapy (RT) in esophageal cancer (EC) patients aged ≥ 80.<h4>Materials and methods</h4>Records for all EC patients aged ≥ 65 years were extracted from the Surveillance, Epidemiology, and End Results database. Chi-square test compared the characteristic and treatment between patients aged ≥ 80 with those aged 65-79. Focusing on patients aged ≥ 80, we employed multivariable logistic regression to identify the association between selection o ...[more]

PMID: 29340114

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Project description:BackgroundColon cancer in older patients represents a major public health issue. As older patients are hardly included in clinical trials, the optimal treatment of these patients remains unclear. The present international EURECCA comparison explores possible associations between treatment and survival outcomes in elderly colon cancer patients.Subjects, materials, and methodsNational data from Belgium, Denmark, The Netherlands, Norway, and Sweden were obtained, as well as a multicenter surgery cohort from Germany. Patients aged 80 years and older, diagnosed with colon cancer between 2001 and 2010, were included. The study interval was divided into two periods: 2001-2006 and 2007-2010. The proportion of surgical treatment and chemotherapy within a country and its relation to relative survival were calculated for each time frame.ResultsOverall, 50,761 patients were included. At least 94% of patients with stage II and III colon cancer underwent surgical removal of the tumor. For stage II-IV, the proportion of chemotherapy after surgery was highest in Belgium and lowest in The Netherlands and Norway. For stage III, it varied from 24.8% in Belgium and 3.9% in Norway. For stage III, a better adjusted relative survival between 2007 and 2010 was observed in Sweden (adjusted relative excess risk [RER] 0.64, 95% confidence interval [CI]: 0.54-0.76) and Norway (adjusted RER 0.81, 95% CI: 0.69-0.96) compared with Belgium.ConclusionThere is substantial variation in the rate of treatment and survival between countries for patients with colon cancer aged 80 years or older. Despite higher prescription of adjuvant chemotherapy, poorer survival outcomes were observed in Belgium. No clear linear pattern between the proportion of chemotherapy and better adjusted relative survival was observed.Implications for practiceWith the increasing growth of the older population, clinicians will be treating an increasing number of older patients diagnosed with colon cancer. No clear linear pattern between adjuvant chemotherapy and better adjusted relative survival was observed. Future studies should also include data on surgical quality.

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Survival benefit evaluation of radiotherapy in esophageal cancer patients aged 80 and older.

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Survival benefit evaluation of radiotherapy in esophageal cancer patients aged 80 and older.

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