The effect of surgery plus chemoradiotherapy on survival of elderly patients with stage Ⅱ–Ⅲ esophageal cancer: a SEER‐based demographic analysis
Open accessAbstract
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.
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Most patients with esophageal cancer are already in stage II to IV when they seek medical help, which brings challenges to treatment and recovery.
“However, most patients with esophageal cancer are already in stage II to IV when they seek medical help, which brings challenges to treatment and recovery [7,8].”
From Symptom Experiences before Medical Help-Seeking and Psychosocial Responses of Patients with Esophageal Cancer: A Qualitative Study. (2023) · cites this paper as [7]
The Introduction says the vast majority of elderly patients with esophageal cancer are already advanced when first diagnosed, and it discusses difficulties in treating elderly patients with locally advanced disease. It does not establish that most patients of all ages present specifically at stages II–IV or that late presentation itself causes the stated treatment and recovery challenges. The indexed passages provide section labels but no page numbers. (LLM, conf=0.86)
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- Authors
- Lv, H., Chao, C., Wang, B., Wang, Z., Qian, Y., & Zhang, X.
- Affiliations
- Soochow University (CN)
- Corresponding author
- Zhang, Xiaoying
- Venue
- Cancer Medicine
- Publisher
- Wiley
- Published
- 2021-11-19
- Volume
- 10
- Issue
- 23
- Pages
- 8483-8496
- ISSN
- 2045-7634 (ISSN-L)
- PMC
- PMC8633220
- OpenAlex
- W3212148677
- Cited by
- 13
- References
- 30
- Citations by year
- 2025: 2 · 2024: 7 · 2023: 3 · 2021: 1
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancer Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gastric Cancer Management and Outcomes
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Keywords
- esophageal cancer, elderly patients, esophagectomy, chemoradiotherapy, trimodality therapy, esophageal adenocarcinoma, overall survival, stage II/III esophageal cancer, SEER
- MeSH terms
- Aged, Combined Modality Therapy, Esophageal Neoplasms, Female, Humans, Male, Neoplasm Staging, Prognosis, Retrospective Studies, United States, Survival Rate, Esophagectomy, SEER Program, Chemoradiotherapy
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