Esophageal cancer in elderly patients: a population-based study

Area of Science:

• Oncology
• Geriatric Medicine
• Cancer Epidemiology

Background:

• Esophageal cancer (EC) incidence is rising, particularly in elderly populations.
• Understanding clinical characteristics and outcomes in older EC patients (≥70 years) is crucial.
• This study compares elderly EC patients to younger counterparts.

Purpose of the Study:

• To investigate clinical features, treatment modalities, and survival outcomes of EC patients aged 70 years and older.
• To compare these aspects with EC patients younger than 70 years.
• To identify prognostic factors and the impact of treatments in elderly EC patients.

Main Methods:

• Analysis of the Surveillance, Epidemiology, and End Results (SEER) database (1973-2013).
• Comparison of patient and treatment characteristics between age groups (≥70 vs. <70).
• Multivariate Cox regression and propensity-score matching (PSA) for survival analyses.

Main Results:

• Elderly patients (≥70) had more females, white race, localized disease, non-adenocarcinoma, and less treatment.
• Older patients exhibited inferior overall survival (HR 1.324) and EC-specific survival (HR 1.270).
• Surgery alone, surgery plus RT, and RT alone were favorable treatments for elderly patients, confirmed by multivariate analysis and PSA.

Conclusions:

• Elderly EC patients (≥70) present unique clinical profiles and worse survival compared to younger patients.
• Despite higher rates of localized disease, older patients received intensive treatments less frequently.
• Intensive treatments are associated with favorable outcomes in elderly EC patients, meriting further investigation.