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Current Oncology
Volume 25
Issue 6
10.3747/co.25.4208
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Article

Outcomes by Treatment Modality in Elderly Patients with Localized Gastric and Esophageal Cancer

by
A. Natori
1,2,
B.A. Chan
1,2,
H.W. Sim
1,2,
L. Ma
1,2,
D.W. Yokom
1,2,
E. Chen
1,2,3,
G. Liu
1,2,3,
G. Darling
1,3,4,
C. Swallow
1,3,5,
S. Brar
1,3,5,
J. Brierley
1,3,
J. Ringash
1,3,
R. Wong
1,3,
J. Kim
1,3,
P. Rogalla
1,3,
S. Hafezi-Bakhtiari
2,3,
J. Conner
5,
J. Knox
1,2,3,
E. Elimova
1,2,3 and
R.W. Jang
1,2,3,*
1
Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2M9, Canada
2
Department of Medicine, University of Toronto, Toronto, ON M5G 2M9, Canada
3
Faculty of Medicine, University of Toronto, Toronto, ON M5G 2M9, Canada
4
Toronto General Hospital, University Health Network, Toronto, ON M5G 2M9, Canada
5
Mount Sinai Hospital, Toronto, ON M5G 2M9, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2018, 25(6), 366-370; https://doi.org/10.3747/co.25.4208
Submission received: 5 September 2018 / Revised: 10 October 2018 / Accepted: 2 November 2018 / Published: 1 December 2018

Abstract

Background: We aimed to assess current treatment patterns and outcomes in elderly patients with localized gastric and esophageal (GE) cancers. Methods: This retrospective analysis considered patients 75 years of age or older with ge cancers treated during 2012–2014. Patient demographics and tumour characteristics were collected. Overall survival (OS) and disease-free survival were assessed by univariable and multivariable Cox proportional hazards regression, adjusting for demographics. Logistic regression analyses were used to examine factors affecting treatment choices. Results: The 110 patients in the study cohort had a median age of 81 years (range: 75–99 years). Primary disease sites were esophageal (55%) and gastric (45%). Treatment received included radiation therapy alone (29%), surgery alone (26%), surgery plus perioperative therapy (14%), chemoradiation alone (10%), and supportive care alone (14%). In multivariable analyses, surgery (hazard ratio: 0.48; 95% confidence interval: 0.26 to 0.90; p = 0.02) was the only independent predictor for improved os. Patients with a good Eastern Cooperative Oncology Group performance status (p = 0.008), gastric disease site (p = 0.02), and adenocarcinoma histology (p = 0.01) were more likely to undergo surgery. Conclusions: At our institution, few patients 75 years of age and older received multimodality therapy for localized ge cancers. Outcomes were better for patients who underwent surgery than for those who did not. To ensure optimal treatment selection, comprehensive geriatric assessment should be considered for patients 75 years of age and older with localized GE cancers.
Keywords: elderly patients; geriatric assessments; gastric cancer; esophageal cancer; treatment selection elderly patients; geriatric assessments; gastric cancer; esophageal cancer; treatment selection

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MDPI and ACS Style

Natori, A.; Chan, B.A.; Sim, H.W.; Ma, L.; Yokom, D.W.; Chen, E.; Liu, G.; Darling, G.; Swallow, C.; Brar, S.; et al. Outcomes by Treatment Modality in Elderly Patients with Localized Gastric and Esophageal Cancer. Curr. Oncol. 2018, 25, 366-370. https://doi.org/10.3747/co.25.4208

AMA Style

Natori A, Chan BA, Sim HW, Ma L, Yokom DW, Chen E, Liu G, Darling G, Swallow C, Brar S, et al. Outcomes by Treatment Modality in Elderly Patients with Localized Gastric and Esophageal Cancer. Current Oncology. 2018; 25(6):366-370. https://doi.org/10.3747/co.25.4208

Chicago/Turabian Style

Natori, A., B.A. Chan, H.W. Sim, L. Ma, D.W. Yokom, E. Chen, G. Liu, G. Darling, C. Swallow, S. Brar, and et al. 2018. "Outcomes by Treatment Modality in Elderly Patients with Localized Gastric and Esophageal Cancer" Current Oncology 25, no. 6: 366-370. https://doi.org/10.3747/co.25.4208

APA Style

Natori, A., Chan, B. A., Sim, H. W., Ma, L., Yokom, D. W., Chen, E., Liu, G., Darling, G., Swallow, C., Brar, S., Brierley, J., Ringash, J., Wong, R., Kim, J., Rogalla, P., Hafezi-Bakhtiari, S., Conner, J., Knox, J., Elimova, E., & Jang, R. W. (2018). Outcomes by Treatment Modality in Elderly Patients with Localized Gastric and Esophageal Cancer. Current Oncology, 25(6), 366-370. https://doi.org/10.3747/co.25.4208

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