Neoadjuvant chemoradiation is associated with improved overall survival in older patients with esophageal cancer
Neoadjuvant chemoradiation is associated with improved overall survival in older patients with esophageal cancer
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DOI：
10.1016/j.jgo.2017.08.010
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发表时间：
2018-01-01
影响因子：
3
通讯作者：
Swisher-McClure, Samuel
中科院分区：
文献类型：
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作者：
Guttmann, David M.;Mitra, Nandita;Swisher-McClure, Samuel
目的：本研究的目的是描述与食管切除术前新辅助放化疗相关的结果，与单纯食管切除术相比，在老年食管癌patients with esophageal cancer.Materials and Methods：我们在2006年至2012年使用国家癌症数据库进行了一项观察性队列研究，患者年龄≥ 70岁，接受食管切除术+/-新辅助放化疗。开发了一个考克斯比例风险模型，使用倾向评分进行治疗加权的逆概率（IPTW），以评估三联治疗与总生存期之间的相关性。围手术期并发症和病理结果与三联疗法进行了鉴定与多变量logistic regression.Results：1364例患者被纳入，平均年龄为75岁（范围70-90）。904例（66%）采用三联疗法治疗，460例（34%）仅采用食管切除术治疗。在IPTW考克斯分析中，新辅助放化疗与总生存率的改善相关（HR = 0.76，95%CI [0.70-0.82]，p
Objectives: The aim of this study was to characterize outcomes associated with neoadjuvant chemoradiation prior to esophagectomy, compared to esophagectomy alone, in older patients with esophageal cancer.Materials and Methods: We conducted an observational cohort study in patients >= 70 years with locally-advanced esophageal cancer undergoing esophagectomy +/- neoadjuvant chemoradiation between 2006 and 2012 using the National Cancer Database. A Cox proportional hazards model with inverse probability of treatment weighting (IPTW) using the propensity score was developed to assess the association between trimodality therapy and overall survival. Perioperative complications and pathologic outcomes associated with trimodality therapy were identified with multivariable logistic regression.Results: 1364 patients were included; the mean age was 75 (range 70-90). 904 (66%) were treated with trimodality therapy and 460 (34%) were treated with esophagectomy alone. On IPTW Cox analysis, neoadjuvant chemoradiation was associated with improved overall survival (HR = 0.76, 95%CI [0.70-0.82], p