Treatment of esophageal cancer in patients over 80 years old

Chino, Osamu; Makuuchi, Hiroyasu; Machimura, Takao; Mizutani, Kyouichi; Sasaki, Hideo; Kanno, Kazuyoshi; Nishi, Takayuki; Tanaka, Hikaru; Sasaki, Takuma; Tajima, Tomoo; Mitomi, Toshio; Sugihara, Takashi

doi:10.1007/bf01366933

Cited by 13 publications

(15 citation statements)

References 14 publications

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“…The palliative treatment performed in this series was mainly the placement of an esophageal prosthesis, in order to allow patients to manage oral intake and maintain a discrete quality of life. Other palliative options, namely radiation therapy or chemotherapy, pose several problems when applied to very old patients [9]. As for radiotherapy, since advanced cancer is common in elderly patients, wide radiation fields should be used, with consequent risk of bone marrow suppression and radiation sickness.…”

Section: Discussionmentioning

confidence: 99%

Management of esophageal cancer in patients aged over 80 years

Ruol

Portale

Castoro

et al. 2007

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Management of esophageal cancer in patients aged over 80 years

Ruol

Portale

Castoro

et al. 2007

European Journal of Cardio-Thoracic Surgery

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“…The patient's age, multiple comorbidities, and poor performance status often become critical fatal issues for the patients during and after surgery or CRT/RT. Therefore, it is very important to evaluate the comorbidity carefully when determining the additional treatments (30)(31)(32)(33).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

et al. 2015

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Objective The standard treatment for submucosal esophageal cancer is esophagectomy or chemoradiotherapy (CRT). However, these treatment modalities could deteriorate the general condition and quality of life of the patients who are intolerant to invasive therapy. It is therefore important and beneficial to develop less invasive treatment protocols for these patients. Methods The study included 43 patients who were clinically suspected of mucosa or submucosal esophageal cancer but underwent endoscopic submucosal dissection (ESD) as a primary treatment, due to the patients' poor performance statuses and/or preferences for less invasive therapy. According to the pathological findings and patient's general condition, whether the patient underwent additional treatments or remained hospitalized without additional treatments was thereafter decided for each patient. We retrospectively analyzed the outcomes of these patients. Results Fifteen patients underwent additional surgery, 11 patients underwent CRT/radiation therapy (RT) and 17 patients were followed without additional treatments. During the 3-year follow-up period, the relapsefree survival rates in the patients who received or did not receive additional treatments were 88% and 64%, respectively (95% confidence interval, 0.45-0.76, p=0.04). The relapse-free and overall survival rates in the patients with additional treatments were equivalent or superior to those described in previous reports of the standard treatments. Preceding ESD contributed to reduce the local relapse significantly to approximately 3.5% and additional CRT-related toxicities. Conclusion Preceding ESD is very effective for the local control of cancer, and useful for histologically confirming the high-risk factors of relapse, such as ! submucosal layer 2 (SM2) invasion and lymphovascular involvements. ESD with additional therapy may be a promising strategy for optimizing the selection of therapy depending on the patient's general condition.

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“…Esophagectomy, a standard treatment for younger patients with early disease, is less frequently performed in elderly patients. Postoperative mortality rates in patients aged 70 years and older range from 4.5 to 23 % and may even reach 60 % [1][2][3]. In France, definitive chemoradiotherapy (CRT) is an accepted standard treatment for all patients with locally advanced squamous cell carcinoma who cannot undergo surgery [4].…”

Section: Introductionmentioning

confidence: 99%