Lorenzen Sylvie1, Spoerl Silvia2, Al-Batran Salah-Eddin3, Feith Markus4, Lordick Florian5, Thuss-Patience Peter6, Haller Bernhard7, Angele Martin8, Novotny Alexander4. 1. 3rd Department of Internal Medicine (Hematology/Medical Oncology), Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: sylvielorenzen@gmx.de. 2. 3rd Department of Internal Medicine (Hematology/Medical Oncology), Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 3. Krankenhaus Nordwest, UCT University Cancer Center, Frankfurt am Main, Germany. 4. Department of Surgery, Klinikum rechts der Isar der Technischen Universitaet Muenchen, Muenchen, Germany. 5. University Cancer Center Leipzig (UCCL), University Medicine Leipzig, University of Leipzig, Leipzig, Germany. 6. Department of Haematology, Oncology and Tumorimmunology, Campus Virchow-Klinikum, Charite-University Medicine Berlin, Berlin, Germany. 7. Institute for Medical Statistics and Epidemiology, Technische Universität München, Munich, Germany. 8. Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of München, Munich, Germany.
Abstract
INTRODUCTION: Neoadjuvant chemotherapy (neoCTx) improves the prognosis of patients with localised oesophagogastric adenocarcinoma (EGC), but its value is unknown in elderly patients. PATIENTS AND METHODS: Patients who received neoCTx followed by surgery for EGC between 2000 and 2012 were analysed. The aim of this study was to compare the feasibility and outcome between patients aged ⩾70 (cohort I) and their younger counterparts (cohort II). RESULTS: Data were available for 460 patients among which 174 (38%) were ⩾70 years. Older age was associated with an increased rate of comorbidities (66% versus 42%, p<0,001). As compared to the younger, elderly patients were more likely to receive doublet instead of triplet neoCTx (65% versus 37%, p<0.001) and oxaliplatin-instead of cisplatin-based regimens (60% versus 32%, p<0.001). No significant difference was observed in the rate of ⩾grade 3 toxicities for cohort I and II (48% versus 41%) and postoperative morbidity was also not different (24% versus 28%). 90 day mortality for cohort I and II was 6.5% and 3.9%. After a median follow-up of 38 months, median disease-free survival (DFS) was 29.4 months in cohort I and 33.8 months in cohort II, with a 5-years DFS of 37% and 40%, respectively. Median overall survival (OS) was not reached in cohort I and was 58.4 months in cohort II, with a 5-year OS of 51% and 50% for cohort I and II, respectively. DISCUSSION: Despite slightly more adverse events and dose reductions, neoCTx is feasible in elderly patients with EGC. Elderly patients achieve comparable survival outcomes compared with their younger counterparts.
INTRODUCTION: Neoadjuvant chemotherapy (neoCTx) improves the prognosis of patients with localised oesophagogastric adenocarcinoma (EGC), but its value is unknown in elderly patients. PATIENTS AND METHODS: Patients who received neoCTx followed by surgery for EGC between 2000 and 2012 were analysed. The aim of this study was to compare the feasibility and outcome between patients aged ⩾70 (cohort I) and their younger counterparts (cohort II). RESULTS: Data were available for 460 patients among which 174 (38%) were ⩾70 years. Older age was associated with an increased rate of comorbidities (66% versus 42%, p<0,001). As compared to the younger, elderly patients were more likely to receive doublet instead of triplet neoCTx (65% versus 37%, p<0.001) and oxaliplatin-instead of cisplatin-based regimens (60% versus 32%, p<0.001). No significant difference was observed in the rate of ⩾grade 3 toxicities for cohort I and II (48% versus 41%) and postoperative morbidity was also not different (24% versus 28%). 90 day mortality for cohort I and II was 6.5% and 3.9%. After a median follow-up of 38 months, median disease-free survival (DFS) was 29.4 months in cohort I and 33.8 months in cohort II, with a 5-years DFS of 37% and 40%, respectively. Median overall survival (OS) was not reached in cohort I and was 58.4 months in cohort II, with a 5-year OS of 51% and 50% for cohort I and II, respectively. DISCUSSION: Despite slightly more adverse events and dose reductions, neoCTx is feasible in elderly patients with EGC. Elderly patients achieve comparable survival outcomes compared with their younger counterparts.
Authors: Natalie Liu; Daniela Molena; Miloslawa Stem; Amanda L Blackford; David B Sewell; Anne O Lidor Journal: J Gastrointest Surg Date: 2018-02-05 Impact factor: 3.452
Authors: T P MacGregor; R Carter; R S Gillies; J M Findlay; C Kartsonaki; F Castro-Giner; N Sahgal; L M Wang; R Chetty; N D Maynard; J B Cazier; F Buffa; P J McHugh; I Tomlinson; M R Middleton; R A Sharma Journal: Sci Rep Date: 2018-05-08 Impact factor: 4.379