KEY TAKEAWAYS
- The study aimed to investigate the evolution of prognosis and factors influencing non-EC deaths in older patients with EC after definitive chemoradiotherapy.
- Researchers noticed that survival probability rises with time for older EC patients receiving chemoradiotherapy, underscoring the need to manage age-related comorbidities.
Definitive chemoradiotherapy is a primary treatment option for older patients with esophageal cancer (EC). However, understanding the evolving prognosis and factors influencing non-EC deaths in this population is lacking.
Xiao Chang and the team aimed to investigate the conditional survival and annual hazard of death in older patients with EC after chemoradiotherapy.
They performed an inclusive analysis using data from patients aged 65 or older with EC registered in the Surveillance, Epidemiology, and End Results database from 2000 to 2019. Conditional survival, indicating the probability of survival given a specific time survived, and annual hazard of death, defined as the yearly event rate, were assessed. The association of age at diagnosis with mortality was identified through Restricted Cubic Spline (RCS) analysis.
The study observed that among 3739 patients, the 3-year conditional overall survival increased annually by 7-10%. Non-EC causes accounted for 18.8% of deaths, predominantly due to cardio-cerebrovascular diseases. The hazard of death decreased from 40 to 10% in the first 6 years and then gradually increased to 20% in the tenth year. Non-EC causes surpassed EC causes in hazard starting 5 years post-treatment. RCS indicated a consistent increase in death hazard with advancing age, following a linear relationship.
The overall cohort was divided into 2 groups which were 65-74 and ≥ 75 years old, with the ≥ 75-year-old group showing poorer survival and earlier onset of non-EC deaths (HR = 1.36, 95% CI: 1.15-1.62, P < 0.001). Patients with early-stage disease (I-II) had higher risks of death from non-EC causes (HR = 0.82, 95% CI: 0.68-0.98, P = 0.035). Tumor histology had no significant impact on non-EC death risk (HR = 1.17, 95% CI: 0.98-1.39, P = 0.081).
The study concluded that survival probability escalates over time for older patients with EC undergoing chemoradiotherapy. Clinicians and patients should prioritize managing and preventing age-related comorbidities, particularly in older cohorts and those with early-stage disease.
The study was sponsored by the Beijing Hospitals Authority’s Ascent Plan, the National Natural Science Foundation, the Beijing Municipal Science & Technology Commission, and the Beijing Hospitals Authority Clinical medicine Development of special funding support.
Source: https://pubmed.ncbi.nlm.nih.gov/38632503/
Chang X, Deng W, Yu R, et al. (2024). “Conditional survival and annual hazard of death in older patients with esophageal cancer receiving definitive chemoradiotherapy.” BMC Geriatr. 2024 Apr 17;24(1):348. doi: 10.1186/s12877-024-04939-w. PMID: 38632503; PMCID: PMC11025141.
