Clinical Oncology
Volume 22, Issue 7 , Pages 578-585 , September 2010

Prognostic Significance of Age in the Radical Treatment of Oesophageal Cancer with Surgery or Chemoradiotherapy: a Prospective Observational Cohort Study

  • Ll. Davies

      Affiliations

    • Department of Surgery, University Hospital of Wales, Cardiff, UK
    • ,
  • W.G. Lewis

      Affiliations

    • Department of Surgery, University Hospital of Wales, Cardiff, UK
    • Corresponding Author InformationAuthor for correspondence: W.G. Lewis, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK. Tel: +44-29-2074-3268; Fax: +44-29-2074-4553.
    • ,
  • D.T. Arnold

      Affiliations

    • Department of Surgery, University Hospital of Wales, Cardiff, UK
    • ,
  • X. Escofet

      Affiliations

    • Department of Surgery, University Hospital of Wales, Cardiff, UK
    • ,
  • G. Blackshaw

      Affiliations

    • Department of Surgery, University Hospital of Wales, Cardiff, UK
    • ,
  • S. Gwynne

      Affiliations

    • Department of Oncology, Velindre Hospital, Cardiff, UK
    • ,
  • M. Evans

      Affiliations

    • Department of Oncology, Velindre Hospital, Cardiff, UK
    • ,
  • S.A. Roberts

      Affiliations

    • Department of Radiology, University Hospital of Wales, Cardiff, UK
    • ,
  • I. Appadurai

      Affiliations

    • Department of Anaesthetics, University Hospital of Wales, Cardiff, UK
    • ,
  • T.D. Crosby

      Affiliations

    • Department of Oncology, Velindre Hospital, Cardiff, UK

Received 15 November 2009 ,Revised 22 March 2010 ,Accepted 8 April 2010.

References 

  1. Medical Research Council Oesophageal Cancer Working Group . Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet. 2002;359:1727–1733
  2. Crosby T. Scottish Intercollegiate Guidelines Network (SIGN) 87 – the Management of Oesophageal and Gastric Cancer. Clin Oncol. 2008;20(7):528–529
  3. Alderson D. Scottish Intercollegiate Guidelines Network (SIGN) 87 – the Management of Oesophageal and Gastric Cancer. Clin Oncol. 2008;20(7):530–531
  4. Willett CG, Czito BG. Chemoradiotherapy in gastrointestinal malignancies. Clin Oncol. 2009;21(7):543–556
  5. Morgan MA, Lewis WG, Chan DSY, et al. Influence of socio-economic deprivation on outcomes for patients diagnosed with oesophageal cancer. Scand J Gastroenterol. 2007;42(10):1230–1237
  6. Kelsen DP, Ginsberg R, Pajak TF, et al. Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer. N Engl J Med. 1998;339(27):1979–1984
  7. Blazeby JM, Metcalfe C, Nicklin J, Barham CP, Donovan J, Alderson D. Association between quality of life scores and short-term outcome after surgery for cancer of the oesophagus or gastric cardia. Br J Surg. 2005;92(12):1502–1578
  8. Crosby TD, Brewster AE, Borley A, et al. Definitive chemoradiation in patients with inoperable oesophageal carcinoma. Br J Cancer. 2005;90:70–75
  9. Extremes of Age, The 1999 report of the National Confidential Enquiry into Perioperative Deaths. London: NCEPOD; 1999.
  10. Finlayson E, Fan Z, Birkmeyer JD. Outcomes in octogenarians undergoing high-risk cancer operation: a national study. J Am Coll Surg. 2007;205(6):729–734
  11. Weaver S, Blackshaw G, Lewis WG, Edwards P, Roberts SA, Thomas GV. Comparison of special interest computerised tomography, endosonography and histopathological stage of oesophageal cancer. Clin Radiol. 2004;59:499–504
  12. Korst RJ, Rusch VW, Venkatraman E, Bains MS, Burt ME, Downey RJ. Proposed revision of the staging classification for esophageal cancer. J Thorac Cardiovasc Surg. 1998;115(3):660–669
  13. Rizk N, Venkatraman E, Park B, Flores R, Bains MS, Rusch V. The prognostic importance of the number of involved lymph nodes in esophageal cancer: implications for revisions of the American Joint Committee on Cancer staging system. J Thorac Cardiovasc Surg. 2006;132(6):1374–1381
  14. Eloubeidi MA, Desmond R, Arguedas MR, Reed CE, Wilcox CM. Prognostic factors for the survival of patients with esophageal carcinoma in the U.S.: the importance of tumor length and lymph node status. Cancer. 2002;95(7):1434–1443
  15. Gu Y, Swisher SG, Ajani JA, Correa AM, Hofstetter WL, Liao Z. The number of lymph nodes with metastasis predicts survival in patients with esophageal or esophagogastric junction adenocarcinoma who receive preoperative chemoradiation. Cancer. 2006;106(5):1017–1025
  16. Mariette C, Piessen G, Briez N, Triboulet JP. The number of metastatic lymph nodes and the ratio between metastatic and examined lymph nodes are independent prognostic factors in esophageal cancer regardless of neoadjuvant chemoradiation or lymphadenectomy extent. Ann Surg. 2008;247(2):365–371
  17. Tachibana M, Yoshimura H, Kinugasa S, Dhar DK, Shibakita M, Ohno S. Clinicopathologic factors correlated with number of metastatic lymph nodes in oesophageal cancer. Dig Liver Dis. 2001;33(7):534–538
  18. Kennedy BJ. The unified international gastric cancer staging classification. Scand J Gastroenterol. 1987;22(Suppl. 133):11–13
  19. In:  Sobin LH,  Wittekind C editor. UICC TNM classification of malignant tumors. 5th ed.. New York: John Wiley; 1997;
  20. Morgan M, Lewis WG, Hopper N, et al. Prospective cohort comparison of neoadjuvant chemoradiotherapy versus chemotherapy for patients diagnosed with oesophageal cancer. Br J Surg. 2007;94(12):1509–1514
  21. Lewis I. The surgical treatment of carcinoma of the oesophagus, with special reference to new operation for growths of middle third. Br J Surg. 1946;34:18–31
  22. Tanner IC. The present position of carcinoma of the oesophagus. Postgrad Med J. 1947;23:109–139
  23. Orringer MB. Transhiatal oesophagectomy without thoracotomy for carcinoma of the thoracic esophagus. Ann Surg. 1984;200:282–288
  24. National Cancer Institute . Common terminology criteria for adverse events. http://ctep.cancer.gov/forms/CTCAEv3.pdf
  25. Blackshaw G, Davies L, Escofet X, et al. Influence of age on outcome after radical treatment of esophageal cancer with surgery or chemoradiotherapy (dCRT). J Clin Oncol. 2009;27(Suppl.):15s;[abstract 4569]
  26. Davies L, Escofet X, Blackshaw G, et al. Prognostic significance of age in the stage directed treatment of oesophageal cancer with radical intent. Br J Surg. 2009;96(S4):63
  27. Kaplan EL, Meier P. Non-parametric estimation from incomplete observations. J Am Stat Assoc. 1958;58:457–481
  28. Cox DR. Regression models and life tables. J R Stat Soc. 1972;B:187–200
  29. Priebe HJ. The aged cardiovascular risk patient. Br J Anaesth. 2000;85(5):763–778
  30. Stephens MR, Lewis WG, Brewster AE, et al. Multidisciplinary teams are associated with improved outcomes after esophagectomy for carcinoma. Dis Esophagus. 2006;19:164–171
  31. Adams R, Morgan M, Mukherjee S, et al. A prospective comparison of multidisciplinary treatment of oesophageal cancer with curative intent in a UK cancer network. Eur J Surg Oncol. 2007;33:307–313
  32. Morgan MA, Burrow S, Goricha D, et al. Prognostic significance of body mass indices for patients undergoing esophagectomy for cancer. Dis Esophagus. 2007;20(Suppl. 1):29–35
  33. Morgan M, Lewis WG, Escofet X, et al. Prospective comparison of transthoracic versus transhiatal oesophagectomy following neoadjuvant chemotherapy for oesophageal cancer. Dis Esophagus. 2007;20:225–231
  34. Bonnetain F, Bouche O, Michel P, et al. A comparative longitudinal quality of life study using the Spitzer quality of life index in a randomized multicenter phase III trial (FFCD 9102): chemoradiation followed by surgery compared with chemoradiation alone in locally advanced squamous respectable thoracic esophageal cancer. Ann Oncol. 2006;17:827–834
  35. Adam DJ, Craig SR, Sang CT, Cameron EW, Walker WS. Esophagectomy for carcinoma in the octogenarian. Ann Thorac Surg. 1996;61(1):190–194
  36. Ellis FH, Williamson WA, Heatley GJ. Cancer of the esophagus and cardia: does age influence treatment selection and surgical outcomes?. J Am Coll Surg. 1998;187(4):345–351
  37. Kinugasa S, Tachibana M, Yoshimura H, et al. Esophageal resection in elderly esophageal carcinoma patients: improvement in postoperative complications. Ann Thorac Surg. 2001;71(2):414–418
  38. Sabel MS, Smith JL, Nava HR, Mollen K, Douglass HO, Gibbs JF. Esophageal resection for carcinoma in patients older than 70 years. Ann Surg Oncol. 2002;9(2):210–214
  39. Takeno S, Takahashi Y, Watanabe S, et al. Esophagectomy in patients aged over 80 years with esophageal cancer. Hepatogastroenterology. 2008;55(82–83):453–456
  40. Bonavina L, Incarbone R, Saino G, Clesi P, Peracchia A. Clinical outcome and survival after esophagectomy for carcinoma in elderly patients. Dis Esophagus. 2003;16(2):90–93
  41. Internullo E, Moons J, Nafteux P, et al. Outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years. Eur J Cardiothorac Surg. 2008;33(6):1096–1104
  42. Morita M, Egashira A, Yoshida R, et al. Esophagectomy in patients 80 years of age and older with carcinoma of the thoracic esophagus. J Gastroenterol. 2008;43(5):345–351
  43. Ruol A, Portale G, Castoro C, et al. Management of esophageal cancer in patients aged over 80 years. Eur J Cardiothorac Surg. 2007;32(3):445–448
  44. Rahamim JS, Murphy GJ, Awan Y, Junemann-Ramirez M. The effect of age on the outcome of surgical treatment for carcinoma of the oesophagus and gastric cardia. Eur J Cardiothorac Surg. 2003;23(5):805–810
  45. Park DP, Welch CA, Harrison DA, et al. Outcomes following oesophagectomy in patients with oesophageal cancer: a secondary analysis of the ICNARC Case Mix Program Database. Crit Care. 2009;13(2):S1
  46. Flamen P, Lerut A, Van Custem E, De Wever W, Peeters M, Stroobants S. Utility of positron emission tomography for the staging of potentially operable esophageal carcinoma. J Clin Oncol. 2000;18:3202–3210
  47. Kim K, Park SJ, Kim BT, Lee KS, Shim YM. Evaluation of lymph node metastases in squamous cell carcinoma of the esophagus with positron emission tomography. Ann Thorac Surg. 2001;71:290–294
  48. Hulscher JBF, Tifssen JGP, Obertop H, van Lanschot JJB. Transthoracic versus transhiatal resection for carcinoma of the esophagus: a meta-analysis. Ann Thorac Surg. 2001;72(Suppl. 1):306–313
  49. Sykes AJ, Burt PA, Slevin NJ, Stout R, Marrs JE. Radical radiotherapy for carcinoma of the oesophagus: and effective alternative to surgery. Radiother Oncol. 1998;48:15–21
  50. Wong R, Mathener R. Combined chemotherapy and radiotherapy (without surgery) compared with radiotherapy alone in localized carcinoma of the esophagus. Cochrane Syst Rev. 2006;
  51. Morgan MA, Lewis WG, Casbard A, et al. Prospective cohort stage for stage comparison of definitive chemoradiation, surgery alone and neoadjuvant chemotherapy for oesophageal carcinoma. Br J Surg. 2009;96(11):1300–1307
  52. Forshaw MJ, Strauss DC, Davies AR, et al. Is cardiopulmonary exercise testing a useful test before esophagectomy?. Ann Thorac Surg. 2008;85:294–299
  53. Hall A, Older P. Cardiopulmonary exercise testing accurately predicts risk of major surgery including esophageal resection. Ann Thorac Surg. 2009;87(2):670–671
  54. Nagamatsu Y, Shima I, Yamana H, Fujita H, Shirouzu K, Ishitake T. Preoperative evaluation of cardiopulmonary reserve with the use of expired gas analysis during exercise testing in patients with squamous cell carcinoma of the thoracic esophagus. J Thorac Cardiovasc Surg. 2001;121(6):1064–1068

PII: S0936-6555(10)00195-0

doi: 10.1016/j.clon.2010.05.023

Clinical Oncology
Volume 22, Issue 7 , Pages 578-585 , September 2010

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