Outcomes after endoscopic versus surgical therapy for early esophageal cancers in an older population

Gastrointestinal Endoscopy
Linda C CummingsGregory S Cooper

Abstract

Endoscopic treatment of early esophageal cancer provides an alternative to esophagectomy, which older patients may not tolerate. Population-based data regarding short-term outcomes and recurrence after endoscopic treatment for esophageal cancer are limited. We compared short-term outcomes, treated recurrence, and survival after endoscopic versus surgical therapy for early esophageal cancers in an older population. We conducted a retrospective cohort study identifying patients aged ≥66 years with Tis or T1a tumors without nodal involvement diagnosed from 1994 to 2011 from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Of 2193 patients, 41% (n = 893) underwent esophagectomy, and 12% (n = 255) underwent endoscopic treatment within 6 months of diagnosis. Those treated endoscopically were older and more likely to have a Charlson comorbidity score ≥2. A composite endpoint, hospitalization and/or adverse events at 60 days, was higher in surgical patients than in the endoscopic treatment group (30% vs 12%; P < .001). In a Cox model stratified by histology, adjusting for other factors, endoscopic treatment was associated with improved 2-year survival (hazard ratio 0.51; 95% CI, 0.36-0.73). In this older...Continue Reading

Citations

May 26, 2017·Expert Opinion on Pharmacotherapy·Elfriede BollschweilerArnulf H Hölscher
Oct 17, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Yuan ZengJianxing He
Sep 1, 2019·Digestive Diseases and Sciences·Joseph SpataroTilak Shah
Aug 26, 2016·Canadian Journal of Gastroenterology & Hepatology·Rajan N AminSumanth Daram
Jan 5, 2019·Annals of Surgical Oncology·Fariha H RamayMelanie A Edwards
Dec 17, 2019·Therapeutic Advances in Gastroenterology·Solène DermineMaximilien Barret
Feb 9, 2021·Clinics and Research in Hepatology and Gastroenterology·Wenjia WangYongbing Chen

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carcinoma, Squamous Cell

Basal cell carcinoma is a form of malignant skin cancer found on the head and neck regions and has low rates of metastasis. Discover the latest research on basal cell carcinoma here.

Cancer Incidence & Mortality

Cancer has emerged as a global concern due to its increase in incidence and mortality. Efforts are underway to evaluate and develop action plans to reduce the global burden of cancer. Currently, lung cancer, breast cancer and prostate cancer are the leading causes of cancer mortality. Here is the latest research on cancer incidence and mortality.