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Open Access Research article

Esophageal cancer in the elderly: an analysis of the factors associated with treatment decisions and outcomes

David Tougeron1*, Hadji Hamidou2, Michel Scotté3, Frédéric Di Fiore1, Michel Antonietti1, Bernard Paillot1 and Pierre Michel1

Author Affiliations

1 Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, Northwest Cancéropôle, 1 rue de Germont, 76031 Rouen Cedex, France

2 Department of Radiotherapy, CRLCC Becquerel, Northwest Cancéropôle, rue d'Amiens, 76000 Rouen, France

3 Department of Digestive Surgery, Rouen University Hospital, Northwest Cancéropôle, 1 rue de Germont, 76031 Rouen Cedex, France

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BMC Cancer 2010, 10:510  doi:10.1186/1471-2407-10-510

Published: 24 September 2010

Abstract

Background

Only limited data has been reported so far regarding oesophageal cancer (EC) in elderly patients. The aim of the study is to identify the baseline parameters that influenced therapeutic decision.

Methods

All consecutive patients 70 years or older being treated for EC were retrospectively analyzed. Patients without visceral metastasis were divided into two groups: treatment with curative intent (chemoradiotherapy, surgery, radiotherapy, mucosectomy or photodynamic therapy) or best supportive care (BSC). Patients with metastasis were divided into two groups: palliative treatment (chemotherapy, chemoradiotherapy or radiotherapy) or BSC.

Results

Two hundred and eighty-two patients were studied. Mean age was 76.5 ± 5.5 years and 22.4% of patients had visceral metastasis. In patients without visceral metastasis (n = 220) the majority had treatment with curative intent (n = 151) whereas in patients with metastasis (n = 62) the majority had BSC (n = 32). Severe adverse events (≥ grade 3) were observed in only 17% of the patients. Patients without specific carcinologic treatment were older, had more weight loss, worse WHO performance status and Charlson score in multivariate analysis.

Discussion

Our results suggest that elderly patients with an EC could benefit from cancer treatment without major toxicities. Weight loss, WHO performance status and the Charlson score could be used to select the appropriate treatment in an elderly patient.