Age was not a significant prognostic factor for long-term survival after transthoracic esophagectomy among patients with thoracic esophageal cancer, according to the results of a retrospective study published online June 13, 2019, in Oncology. The literature to date has yielded conflicting results, with some suggesting older age may be associated with worse survival after the procedure, and others suggesting there is no association between age and survival in this setting.
“The purpose of the present study was to clarify the impact of age on long-term survival in patients with esophageal cancer undergoing esophagectomy using the relative survival ratio and excess hazard model,” the study authors wrote.
The study included 505 thoracic esophageal cancer patients who underwent transthoracic esophagectomy at the Osaka International Cancer Institute during the time period of 1990 to 2002. Patients were followed for a maximum of 10 years after the procedure.
A univariate analysis was first performed to identify candidate variables that were potential confounders for age (ie, P <.25) and identified several candidates, including: gender, tumor location, clinical stage, residual tumor, preoperative adjuvant therapy, postoperative adjuvant therapy, and postoperative complications. A multivariate analysis was then performed to determine which candidate variables should be controlled as confounding variables for age. The investigators identified clinical stage, residual tumor, and postoperative complications as confounders of age (P <.1).
Using a multivariate excess hazard model that included the 3 identified confounders, the study authors found that age was not a significant prognostic factor for survival following transthoracic esophagectomy among patients with thoracic esophageal cancer in any of the age groups. Among patients 70 years or older, however, there was a trend toward an increasing excess hazard ratio of death.
“When clinicians offer esophagectomy for esophageal cancer, age per se should not be a limiting factor,” the study authors concluded.
Motoori M, Ito Y, Miyashiro I, et al. Impact of age on long-term survival in patients with esophageal cancer who underwent transthoracic esophagectomy [published online June 13, 2019]. Oncology. doi: 10.1159/000500604