Evidence map›Paper›PMID 36978040›Full record

ArticleBMC cancer2023

Real-world management and outcomes of older patients with locally advanced esophageal squamous cell carcinoma: a multicenter retrospective study.

Yuki Saito, Yasuo Hamamoto, Kenro Hirata, Makoto Yamasaki, Masaya Watanabe, Tetsuya Abe, Yasuhiro Tsubosa, Yoichi Hamai, Kentaro Murakami, Takeo Bamba and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Yuki SaitoDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Yasuo HamamotoKeio Cancer Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan. yashmmt1971@gmail.com.
Kenro HirataDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Makoto YamasakiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Masaya WatanabeDepartment of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan.
Tetsuya AbeDepartment of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
Yasuhiro TsubosaDivision of Esophageal Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
Yoichi HamaiDepartment of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
Kentaro MurakamiDepartment of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Takeo BambaDepartment of Digestive Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
Takako YoshiiDepartment of Gastroenterology, Saitama Cancer Center, Saitama, Japan.
Masahiro TsudaDepartment of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan.
Masayuki WatanabeDepartment of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Masaki UenoDepartment of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
Yuko KitagawaDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeoadjuvant chemotherapy (NAC) followed by surgery is the standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC). Chemoradiotherapy (CRT) is an alternative treatment approach. However, both treatments are associated with toxicity, and the optimal treatment for older patients with ESCC is unknown. This study aimed to evaluate the treatment strategies and prognosis of older patients with locally advanced ESCC in a real-world setting.

methodsWe retrospectively evaluated 381 older patients (≥ 65 years) with locally advanced ESCC (stage IB/II/III, excluding T4) who received anticancer therapy at 22 medical centers in Japan. Based on age, performance status (PS), and organ function, the patients were classified into two groups: clinical trial eligible and ineligible groups. Patients aged ≤ 75 years with adequate organ function and a PS of 0-1 were categorized into the eligible group. We compared the treatments and prognoses between the two groups.

resultsThe ineligible group had significantly shorter overall survival (OS) than the eligible group (hazard ratio [HR] for death, 1.65; 95% confidence interval [CI], 1.22-2.25; P = 0.001). The proportion of patients receiving NAC followed by surgery was significantly higher in the eligible group than in the ineligible group (P = 1.07 × 10

conclusionsNAC followed by surgery is justified for select older patients who can tolerate radical treatment, even if they are old or vulnerable to enrollment in clinical trials. CRT did not provide survival benefits over radiation alone in patients ineligible for clinical trials, suggesting the need to develop less-toxic CRT.

Indexed as

Esophageal NeoplasmsEsophageal Squamous Cell CarcinomaChemoradiotherapyEsophagectomyHumansNeoadjuvant TherapyPrognosisRetrospective StudiesConcurrent chemoradiotherapyEsophageal squamous cell carcinomaEsophagectomyNeoadjuvant chemotherapyOlderReal-worldSurvivalTreatment

Identifiers

PMID36978040
PMCPMC10053162

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.