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Comparative Study
. 2019 Jul;10(7):1511-1520.
doi: 10.1111/1759-7714.13080. Epub 2019 Jun 14.

Comparative study of esophagectomy, endoscopic therapy, and radiotherapy for cT1N0M0 esophageal cancer in elderly patients: A SEER database analysis

Jianjun Qin  1 , Yinjie Peng  2 , Weipeng Chen  2 , Haibo Ma  2 , Yan Zheng  2 , Yin Li  1 , Jun Wang  3
Affiliations
Comparative Study

Comparative study of esophagectomy, endoscopic therapy, and radiotherapy for cT1N0M0 esophageal cancer in elderly patients: A SEER database analysis

Jianjun Qin et al. Thorac Cancer. 2019 Jul.

Abstract

Background: The number of patients diagnosed with early stage disease (T1a or T1b) has been increasing. This study was conducted to investigate the effect of esophagectomy (ES), endoscopic therapy (ET), and radiotherapy (RT) on long-term survival in elderly patients with cT1N0M0 esophageal cancer.

Methods: We searched the Surveillance, Epidemiology, and End Results (SEER) database to identify the records of elderly patients (≥ 75 years) with cT1N0M0 esophageal cancer between 2004 and 2014. Patient demographics and esophageal cancer parameters were compared among ES, ET, and RT groups. The Kaplan-Meier method and Cox proportional hazard modeling were used to compare long-term survival.

Results: Data from 954 esophageal cancer patients (ES: n = 196; ET: n = 224; RT: n = 534) were identified. Multivariate Cox regression analysis showed that five-year survival in the ET and ES groups was significantly higher than in the RT group. After propensity score matching, we found no difference in five-year survival between ES and ET.

Conclusion: Using SEER data, we identified a significant survival advantage with the use of ES and ET compared to RT in patients with cT1N0M0 esophageal cancer aged > 75 years, while the long-term survival of patients after ET and ES was not significantly different.

Keywords: endoscopic therapy; esophageal cancer; esophagectomy; radiotherapy.

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Figures

Figure 1
Figure 1
Changes in use of esophagectomy (ES), endoscopic therapy (ET), and radiotherapy (RT) from 2004–2009 to 2010–2014 (P < 0.001). (formula image) ET, (formula image) ES and (formula image) RT.
Figure 2
Figure 2
(a) Overall survival (OS) and (b) esophageal cancer‐specific survival (CSS) rates in patients with early esophageal cancer undergoing esophagectomy (ES), endoscopic treatment (ET), or radiotherapy (RT). (formula image) Endoscopic therapy, (formula image) Esophagectomy and (formula image) Radiotherapy. (formula image) Endoscopic therapy, (formula image) Esophagectomy and (formula image) Radiotherapy. (c) OS and (d) esophageal CSS in patients with early esophageal cancer undergoing ES or ET after propensity score matching. (formula image) Esophagectomy and (formula image) Endoscopic therapy. (formula image) Esophagectomy and (formula image) Endoscopic therapy.
See this image and copyright information in PMC

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