Impact of Chemotherapy and Radiotherapy on the Survival of Elderly Esophagus Cancer Patients after Surgery: A SEER Database Analysis

Abstract BackgroundEsophagus cancer (EC) is a common and lethal carcinoma, however, the effectiveness and feasibility of the conventional treatments for the elderly patients with surgery have not been discussed fully. The purpose of the current study is to discuss the potential effect of chemotherapy and radiotherapy on the prognosis.ResultsBy PSM, chemotherapy (sHR: 0.588, 95%CI: 0.453-0.763, P<0.001) and radiotherapy (sHR: 0.652, 95%CI: 0.513-0.83, P<0.001) were showed a negative correlation to the probability of cancer specific death (CSD). Based on the nomogram, patients with poor differentiation, large tumor size, advanced T-staging, lymphatic metastasis and distant metastasis tended to benefit from chemotherapy (HR: 0.441, 95%CI: 0.364-0.533, P < 0.001) or radiotherapy (HR: 0.539, 95%CI: 0.448-0.649, P < 0.001) to decrease the probabilities of CSD, while no benefit or even harm was showed among the low-risk ones. ConclusionAggressive treatment such as chemotherapy or radiotherapy was considered effective for the selective elder patients with EC.

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Impact of chemotherapy and radiotherapy on the survival of elderly esophageal cancer patients undergoing surgery: a SEER database analysis

BMC Gastroenterology ◽

10.1186/s12876-021-02016-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xinrong Li ◽

Jin Zhang ◽

Chenxiao Ye ◽

Junquan Zhu ◽

Kaibo Guo ◽

...

Keyword(s):

Esophageal Cancer ◽

Elderly Patients ◽

Staging System ◽

The Elderly ◽

Potential Effect ◽

Low Risk ◽

Large Tumor ◽

Radio Therapy ◽

Risk Patients ◽

Poor Differentiation

Abstract Background Esophageal cancer (EC) is a common and lethal carcinoma; however, the effectiveness and feasibility of the chemo- and radio-therapy (CRT) for the elderly patients (≥ 70 years) with surgery have not been fully discussed. The purpose of this study was to investigate the potential effect of CRT on the prognosis. Methods A total of 1085 patients (534 CRT patients vs. 551 non-CRT patients) from 1998 to 2016 were collected from the Surveillance, Epidemiology, and End Results database according to the inclusion and exclusion criteria. Using the competing risk regression and survival analysis, an overall estimation of the effectiveness of CRT was performed on a well-balanced cohort via performing propensity score matching. Then, the specific impact of CRT on high- (n = 557) and low-risk (n = 528) cohorts derived from the nomogram’s risk quantification for every patient were further evaluated respectively. Additionally, the advantages of the nomogram model and the conventional tumor, node, metastasis (TNM, 6th revision) staging system were compared. Results A better survival outcome was observed among patients receiving both surgery and CRT than those who underwent surgery alone (HR: 0.55, 95% CI 0.45–0.68, P < 0.001), especially for those with tumors characterized by poor differentiation, large tumor size, advanced T staging, lymphatic metastasis, and distant metastasis (HR: 0.48, 95% CI 0.39–0.59, P < 0.001), while no benefit was observed among the low-risk patients. Furthermore, the newly established nomogram model might be better than the TNM (6th revision) staging system but more data needed. Conclusion Aggressive treatments, such as surgery, chemotherapy, and radiotherapy, were considered effective for selected elderly patients with EC according to the newly established nomogram model.

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Early stage hepatocellular carcinoma in the elderly: A SEER database analysis

Journal of Geriatric Oncology ◽

10.1016/j.jgo.2017.03.002 ◽

2017 ◽

Vol 8 (4) ◽

pp. 277-283 ◽

Cited By ~ 6

Author(s):

Hani Oweira ◽

Ulf Petrausch ◽

Daniel Helbling ◽

Jan Schmidt ◽

Meinrad Mannhart ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Early Stage ◽

The Elderly ◽

Seer Database ◽

Database Analysis

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Neuroblastoma of the elderly, an oncologist’s nightmare: case presentation, literature review and SEER database analysis

Experimental Hematology and Oncology ◽

10.1186/2162-3619-3-20 ◽

2014 ◽

Vol 3 (1) ◽

pp. 20 ◽

Cited By ~ 11

Author(s):

Elisa Rogowitz ◽

Hani M Babiker ◽

Mohammed Kanaan ◽

Rebecca A Millius ◽

Q Ringenberg ◽

...

Keyword(s):

Literature Review ◽

The Elderly ◽

Seer Database ◽

Database Analysis ◽

Case Presentation

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The Clinicopathological Significance of Jagged1 and DLL4 in Gallbladder Cancer

Tumori Journal ◽

10.5301/tj.5000519 ◽

2016 ◽

Vol 103 (6) ◽

pp. 557-565 ◽

Cited By ~ 3

Author(s):

Yuan Luo ◽

Zhu-lin Yang ◽

Chunwei Wang ◽

Xiongying Miao ◽

Zhiyu Liu ◽

...

Keyword(s):

Tumor Size ◽

Cox Regression ◽

Clinicopathological Characteristics ◽

Gastrointestinal Cancers ◽

Large Tumor ◽

Cox Regression Analysis ◽

Large Tumor Size ◽

Kaplan Meier ◽

Poor Differentiation ◽

Clinicopathological Significance

Purpose Gallbladder cancers (GBCs) are highly aggressive gastrointestinal cancers with high mortality. Biological markers for the diagnosis, prognosis, and targeted therapy of GBCs have not been established. Methods The protein expression of Jagged1 and DLL4 in 80 adenocarcinomas (AC) and 46 squamous cell/adenosquamous carcinomas (SC/ASCs) was measured using immunohistochemistry. Results Positive Jagged1 and DLL4 expression in both SC/ASC and AC was significantly associated with poor differentiation, large tumor size, invasion, metastasis, and low surgical curability. Univariate Kaplan-Meier analysis showed that positive Jagged1 and DLL4 expression was significantly associated with mean survival of SC/ASC and AC patients. Multivariate Cox regression analysis showed that positive Jagged1 and DLL4 expression, as well as poor differentiation, large tumor size, high TNM stage, invasion, lymph node metastasis, and low surgical curability are independent poor prognostic factors in both SC/ASC and AC patients. Conclusions Positive Jagged1 and DLL4 expression is closely correlated with severe clinicopathological characteristics and poor prognosis in patients with SC/ASC and patients with AC.

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