80岁以上食管鳞状细胞癌患者的临床结局

Clinical outcomes of esophageal squamous cell carcinoma in patients aged over 80 years.

作者信息

Ryu Dae Gon, Choi Cheol Woong, Kim Su Jin, Park Su Bum, Jang Jin Ook, Son Bong Soo

机构信息

Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

出版信息

Korean J Intern Med. 2025 Mar;40(2):230-242. doi: 10.3904/kjim.2024.201. Epub 2025 Feb 21.

Abstract

BACKGROUND/AIMS: The clinical outcomes and optimal treatment of esophageal squamous cell carcinoma (ESCC) in elderly patients are unclear. This study aimed to assess the clinical outcomes of ESCC in patients aged ≥ 80 years.

METHODS

Medical records of patients diagnosed with ESCC between December 2008 and February 2024 were retrospectively reviewed. In total, 479 patients with ESCC were included and divided into the elderly (n = 52) and younger (n = 427) groups based on age. The clinical outcomes and survival rates, according to treatment, were compared between the two groups.

RESULTS

The median ages of the two groups were 82 years (range, 80-95 yr) and 66 years (41-79 yr). The overall survival was slightly lower in the elderly group; however, no statistical significance (hazard ratio [HR] 1.27, 95% confidence interval [CI] 0.85-1.91; p = 0.238) was observed. No differences were observed in the outcomes or survival between the two groups according to the treatment method (surgery, chemoradiotherapy or radiotherapy alone, and endoscopic resection). The elderly group was more likely to receive no treatment for cancer (30.8% vs. 13.6%, p = 0.002) than the younger group. However, when there was no treatment for cancer in the elderly group, survival was significantly lower than when treatment was administered (HR 0.08, 95% CI 0.03-020; p < 0.001).

CONCLUSION

In patients with ESCC aged ≥ 80 years, active cancer treatment was beneficial, and the results did not differ from those of younger patients.

摘要

背景/目的:老年食管鳞状细胞癌(ESCC)患者的临床结局及最佳治疗方案尚不清楚。本研究旨在评估年龄≥80岁的ESCC患者的临床结局。

方法

回顾性分析2008年12月至2024年2月期间诊断为ESCC的患者的病历。总共纳入479例ESCC患者,并根据年龄分为老年组(n = 52)和年轻组(n = 427)。比较两组根据治疗方法的临床结局和生存率。

结果

两组的中位年龄分别为82岁(范围80 - 95岁)和66岁(41 - 79岁)。老年组的总生存率略低;然而,未观察到统计学显著性差异(风险比[HR] 1.27,95%置信区间[CI] 0.85 - 1.91;p = 0.238)。根据治疗方法(手术、单纯放化疗或放疗以及内镜切除),两组在结局或生存率方面未观察到差异。老年组比年轻组更有可能未接受癌症治疗(30.8%对13.6%,p = 0.002)。然而,当老年组未接受癌症治疗时,生存率显著低于接受治疗时(HR 0.08,95% CI 0.03 - 0.20;p < 0.001)。

结论

在年龄≥80岁的ESCC患者中,积极的癌症治疗是有益的,且结果与年轻患者无异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0352/11938664/be33e2dab5c3/kjim-2024-201f1.jpg

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