Long-term survival of surgical versus non-surgical treatment for esophageal squamous cell carcinoma in patients ≥70 years: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Kexun ¹ , LI Changding ¹ , NIE Xin ¹ , HE Wenwu ¹ , WANG Chenghao ¹ , WANG Kangning ¹ , LIU Guangyuan ¹ , CHEN Junqiang ² , XIAO Zefen ³ , FANG Qiang ¹ , HAN Yongtao ¹ , PENG Lin ¹ ,  WANG Qifeng ⁴ ,  LENG Xuefeng ¹

1. Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, P. R. China;
2. Department of Radiation Oncology, Fujian Provincial Tumor Hospital, Fujian Medical University, Fuzhou, 350014, P. R. China;
3. Department of Radiation Oncology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, 100021, P. R. China;
4. Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, P. R. China;

Corresponding author：

WANG Qifeng, Email: littlecancer@163.com; LENG Xuefeng, Email: doc.leng@uestc.edu.cn

Keywords：

Esophageal squamous cell carcinoma; surgical treatment; conservative treatment; overall survival; elderly patients

DOI：

10.7507/1007-4848.202403062

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Objective To compare the long-term survival of elderly patients with esophageal squamous cell carcinoma (ESCC) treated with surgical versus non-surgical treatment. Methods A retrospective analysis was conducted on the clinical data of elderly patients aged ≥70 years with ESCC who underwent esophagectomy or radiotherapy/chemotherapy at Sichuan Cancer Hospital from January 2009 to September 2017. Patients were divided into a surgical group (S group) and a non-surgical group (NS group) according to the treatment method. The propensity score matching method was used to match the two groups of patients at a ratio of 1∶1, and the survival of the two groups before and after matching was analyzed. Results A total of 726 elderly patients with ESCC were included, including 552 males and 174 females, with 651 patients aged ≥70-80 years and 75 patients aged ≥80-90 years. There were 515 patients in the S group and 211 patients in the NS group. The median follow-up time was 60.8 months, and the median overall survival of the S group was 41.9 months [95%CI (35.2, 48.5)], while that of the NS group was only 24.0 months [95%CI (19.8, 28.3)]. The 1-, 3-, and 5-year overall survival rates of the S group were 84%, 54%, and 40%, respectively, while those of the NS group were 72%, 40%, and 30%, respectively [HR=0.689, 95%CI (0.559, 0.849), P<0.001]. After matching, 138 patients were included in each group, and there was no statistical difference in the overall survival between the two groups [HR=0.871, 95%CI (0.649, 1.167), P=0.352]. Conclusion Compared with conservative treatment, there is no significant difference in the long-term survival of elderly patients aged ≥70 years who undergo esophagectomy for ESCC. Neoadjuvant therapy combined with surgery is still an important choice to potentially improve the survival of elderly patients with ESCC.

Citation： LI Kexun, LI Changding, NIE Xin, HE Wenwu, WANG Chenghao, WANG Kangning, LIU Guangyuan, CHEN Junqiang, XIAO Zefen, FANG Qiang, HAN Yongtao, PENG Lin, WANG Qifeng, LENG Xuefeng. Long-term survival of surgical versus non-surgical treatment for esophageal squamous cell carcinoma in patients ≥70 years: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(5): 619-625. doi: 10.7507/1007-4848.202403062 Copy

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Long-term survival of surgical versus non-surgical treatment for esophageal squamous cell carcinoma in patients ≥70 years: A retrospective cohort study

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