Adenocarcinoma of the esophagus and esophagogastric junction in patients older than 70 years: Results of neoadjuvant radiochemotherapy followed by transthoracic esophagectomy

Camerlo, Antoine; D’Journo, Xavier Benoît; Ouattara, M.; Trousse, Delphine; Doddoli, Christophe; Thomas, Philippe

doi:10.1016/j.jviscsurg.2012.03.006

Cited by 16 publications

(17 citation statements)

References 31 publications

(52 reference statements)

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“…Along this line, previous results showed that a lower 30-day mortality rate after esophagectomy is obtained when surgery is realized in a specialized center (21). Together with previous evidence (22), our results suggest that surgical resection is feasible even in elderly patients, which was not predictable, because age still appears as a risk factor in certain predictive scores (23). …”

Section: Discussionsupporting

confidence: 40%

Radio(chemo)therapy in Elderly Patients with Esophageal Cancer: A Feasible Treatment with an Outcome Consistent with Younger Patients

et al. 2014

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Background: Although the prevalence of esophageal cancer increases in elderly patients, its clinical history and outcome after treatment remain poorly described.Methods: Between January 2001 and December 2011, 58 patients (pts) older than 75 years received 3D-conformal radiotherapy (mean dose 51 Gy) in two French cancer centers. 47/58 (82%) patients received concomitant chemotherapy (with CDDP and/or FU regimens) and 8 patients underwent surgery after primary radiochemotherapy (RCT).Results: Median age was 77.9 years and the performance status (PS) was 0 or 1 in 89%. Tumors were mainly adenocarcinoma of lower esophagus or gastroesophageal junction (n = 51, 89%), T3T4 (n = 54, 95%), and N1 (n = 44, 77%). The mean follow-up was 21.9 months. In the overall population, the median progression-free survival was 9.6 months and median overall survival (OS) was 14.5 months. Using univariate analysis, OS was significantly associated with age (p = 0.048), PS (p < 0.001), and surgery (p = 0.035). 35 (60.3%) and 18 patients (31%) experienced grade 1–2 or 3–4 toxicity, respectively (CTCAE v4.0).Conclusion: Radiochemotherapy in elderly patients is a feasible treatment and its outcome is close to younger patient’s outcome published in the literature. Surgical resection, after comprehensive geriatric assessment, should be recommended as the standard treatment for adenocarcinoma of lower esophagus or gastroesophageal junction in elderly patients with good PS and low co-morbidity profile, as it is in younger patients.

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Section: Discussionsupporting

confidence: 40%

Radio(chemo)therapy in Elderly Patients with Esophageal Cancer: A Feasible Treatment with an Outcome Consistent with Younger Patients

et al. 2014

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“…existing comorbidities patients did not receive chemotherapy due to feared medical complications [24]. As described in former studies [25] we found no survival benefit for patients over 70 years with neoadjuvant treatment when comparing eligible patients. One reason might be the shift towards gastric cancer in the elderly, since this tumor entities is supposed to profit less form preoperative treatment than the more proximal localized AEG [26,27].…”

Section: Journal Of Surgical Oncologysupporting

confidence: 45%

Surgery of gastric cancer and esophageal cancer: Does age matter?

Nienhueser

Kunzmann

Sisic

et al. 2015

Journal of Surgical Oncology

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An exclusion from surgical therapy due to advanced age in general seems not to be justified. However, the decision for a surgical resection in patients over 80 years should be made with caution. pNM-categories and R0-resection remain the most important predictive factors for overall survival in all subgroups. No survival benefit for neoadjuvant treatment in patients over 70 years was found, while women survived longer than men. However, the decision concerning a (radio) chemotherapy should be made individually in each patient.

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“…Camerlo et al stratified 342 patients, who underwent transthoracic esophagectomy into three groups based on age. They showed that nCRT for patients above 70 years with esophageal adenocarcinoma did not increase postoperative morbidity or mortality .…”

Section: Discussionmentioning

confidence: 99%

The effects of neoadjuvant therapy on morbidity and mortality of esophagectomy for esophageal cancer: American college of surgeons national surgical quality improvement program (ACS–NSQIP) 2005–2012

Sabra

Smotherman

Kraemer

et al. 2016

Journal of Surgical Oncology

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Adenocarcinoma of the esophagus and esophagogastric junction in patients older than 70 years: Results of neoadjuvant radiochemotherapy followed by transthoracic esophagectomy

Abstract: Neoadjuvant radiochemotherapy for elderly patients (age above 70 years) with esophageal adenocarcinoma did not seem to increase postoperative morbidity or mortality, nor was there any difference in quality of life, nor any effect on survival, no matter what the age of the patient.

Cited by 16 publications

References 31 publications

Radio(chemo)therapy in Elderly Patients with Esophageal Cancer: A Feasible Treatment with an Outcome Consistent with Younger Patients

Radio(chemo)therapy in Elderly Patients with Esophageal Cancer: A Feasible Treatment with an Outcome Consistent with Younger Patients

Surgery of gastric cancer and esophageal cancer: Does age matter?

The effects of neoadjuvant therapy on morbidity and mortality of esophagectomy for esophageal cancer: American college of surgeons national surgical quality improvement program (ACS–NSQIP) 2005–2012

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