Department of Cancer Prevention/Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, P.R. China.
Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, China.
Cancer Med. 2023 Feb;12(4):4852-4863. doi: 10.1002/cam4.5307. Epub 2022 Oct 10.
Esophageal cancer (EC) often occurs in the elderly, and approximately 40% of patients are 70 years or older. To investigate the long-term survival of EC in elderly patients, to provide a theoretical direction for better management and predicting survival of EC based on the hospital-based multi-center study in China.
The study was conducted in 18 hospitals including 6 provincial hospitals, 8 municipal hospitals, and 4 county hospitals. We extracted information from medical record homepage, records of admission and discharge, and pathological diagnosis reports from the medical record department of the elderly patients at 70-84 years old to obtain the 3-year and 5-year overall survival (OS), and main associated factors, and to analyze the current therapeutic effect of different treatment options for elderly patients.
The 3-year and 5-year OS rate of the 1013 elderly patients was 44.8% and 32.8%, respectively. Their median survival was 28.00 months. The median survival of patients with squamous cell carcinoma was longer than that of other pathological type (squamous vs. other types: 31.00 vs. 20.00 months, p = 0.018). The median survival of patients with surgery only or combined therapy was longer than that of radiotherapy, chemotherapy, and no therapy (surgery only vs. combined therapy vs. radiotherapy vs. chemotherapy vs. no therapy: 56.00 vs. 33.00 vs. 26.00 vs.18.00 vs. 16.00 months, p < 0.001). The 5-year OS rate of patients with highly differentiated cancer was higher than that of medium differentiated and poor differentiation/undifferentiated. In multivariate analysis, the older ages, pathological stage, were independent prognostic risk factors for poor EC survival. Treatment method was independent protective factors predictive of a good EC OS.
The survival rate of the elderly EC patients was still low in China. Age, therapy method, and pathological stage were mainly associated with the survival rate of EC in elderly patients.
食管癌（EC）常发生于老年人，约 40%的患者年龄在 70 岁及以上。本研究旨在通过中国多中心基于医院的研究，探讨高龄食管癌患者的长期生存情况，为更好地管理和预测食管癌的生存提供理论依据。
该研究在 18 家医院开展，包括 6 家省级医院、8 家市级医院和 4 家县级医院。我们从医院病历首页、入院和出院记录以及病历部门的病理诊断报告中提取信息，以获取 70-84 岁高龄患者的 3 年和 5 年总生存率（OS）及主要相关因素，并分析不同治疗方案对高龄患者的当前治疗效果。
1013 例老年患者的 3 年和 5 年 OS 率分别为 44.8%和 32.8%，中位生存时间为 28.00 个月。鳞癌患者的中位生存时间长于其他病理类型（鳞癌 vs. 其他类型：31.00 个月 vs. 20.00 个月，p=0.018）。仅手术或联合治疗患者的中位生存时间长于放疗、化疗和无治疗患者（仅手术 vs. 联合治疗 vs. 放疗 vs. 化疗 vs. 无治疗：56.00 个月 vs. 33.00 个月 vs. 26.00 个月 vs. 18.00 个月 vs. 16.00 个月，p<0.001）。高分化癌患者的 5 年 OS 率高于中分化和低分化/未分化癌患者。多因素分析显示，年龄较大、病理分期是影响 EC 不良预后的独立危险因素，治疗方法是 EC 总生存的独立保护因素。
中国高龄食管癌患者的生存率仍较低。年龄、治疗方法和病理分期是影响高龄食管癌患者生存的主要因素。
