Management of elderly patients with esophageal squamous cell cancer

Abstract

This review focuses on the treatment about elderly esophageal cancer to clarify the current situation regarding our clinical question. Although there are several reviews about elderly esophageal cancer treatment, there are fundamental differences between Japan and the rest of the world. Two main differences are raised: histological differences and treatment strategies for resectable patients. We overview each status according to following clinical questions. First, there are no established evaluation criteria for frail. Second, selection criteria for surgery or non-surgery are not established. Third, few specific treatments for elderly patients (EPs) are investigated. In conclusion, there are many reports about treatment of esophageal squamous cell carcinoma for EPs, although treatment strategy is still controversial. We have to consider well-designed prospective trial to confirm specific treatment strategy according to each stage.

Survival Impacts of Impaired Lung Functions and Comorbidities on Elderly Esophageal Cancer Patients

“…However, the survival benefit of esophagectomy remains controversial in elderly patients with EC [14], especially those with significant comorbidities [37]. While less invasive treatment strategies, such as endoscopic resection or chemoradiotherapy, are reportedly indicated for frail elderly patients [38,39], the benefit of CRT remains controversial, especially for [14], although optimal selection criteria have yet to be established [10]. Whether our newly proposed survival prediction model is useful for determining surgical indications merits further study.…”

“…While less invasive treatment strategies, such as endoscopic resection or chemoradiotherapy, are reportedly indicated for frail elderly patients [38, 39], the benefit of CRT remains controversial, especially for super‐elderly patients with EC [40]. In general, surgical indications should not be determined based solely on chronological age [14], although optimal selection criteria have yet to be established [10]. Whether our newly proposed survival prediction model is useful for determining surgical indications merits further study.…”

“…The number of elderly patients with EC has been increasing, and approximately 20% of EC patients in Japan are reportedly ≥75 years of age [10, 11]. Previous studies have revealed advanced age to be significantly associated with high short‐term mortality and poor long‐term survival [12, 13] and have further suggested esophagectomy to provide a small survival benefit for octogenarians [14].…”

Real-world management and outcomes of older patients with locally advanced esophageal squamous cell carcinoma: a multicenter retrospective study

“…Both treatment strategies are associated with toxicity [3,11], high mortality, and increased complication rates in older patients [12][13][14]. Therefore, it is unclear whether NAC followed by surgery or definitive CRT is well tolerated and suitable for older patients in a clinical setting [15]. This study aimed to evaluate the treatment strategies and clinical outcomes in older patients with locally advanced ESCC in a real-world setting.…”

Preoperative osteopenia is associated with prognosis in patients after resection of esophageal cancer

“…condition due to underlying diseases and nutritional status affect their prognosis, and there are currently no clear indications for surgery or criteria for treatment selection. 9 As an indicator of nutrition status, the prognostic nutrition index (PNI) has been reported to be a useful biomarker for patients with esophageal cancer undergoing surgery. [10][11][12] In recent years, various indices have been used in reports showing that preoperative frailty and sarcopenia in patients with gastrointestinal malignancies, including esophageal cancer, are associated with postoperative prognosis.…”