Evidence map›Paper›PMID 39046894›Full record

ArticleThe oncologist2024

Outcomes in older adults with metastatic esophageal and gastric carcinoma treated with palliative chemotherapy.

Xin Wang, Michael J Allen, Osvaldo Espin-Garcia, Chihiro Suzuiki, Yvonne Bach, Elan Panov, Lucy X Ma, Raymond W Jang, Eric X Chen, Gail E Darling and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The oncologist, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Article
  2. Observational
  3. Systemic therapy strategies for elderly patients with gastric cancer.Therapeutic advances in medical oncology · 2025
    Review
  4. Article
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

17 authors.

Xin WangDivision of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto ON, Canada.ORCID 0000-0001-6292-3087
Michael J AllenDivision of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto ON, Canada.ORCID 0000-0001-5091-5995
Osvaldo Espin-GarciaDepartment of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Chihiro SuzuikiDivision of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto ON, Canada.
Yvonne BachDivision of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto ON, Canada.
Elan PanovDivision of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto ON, Canada.
Lucy X MaDivision of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto ON, Canada.
Raymond W JangDivision of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto ON, Canada.
Eric X ChenDivision of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto ON, Canada.
Gail E DarlingDivision of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Jonathan YeungDivision of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada.ORCID 0000-0001-5759-3028
Carol J SwallowDepartment of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Savtaj Singh BrarDepartment of Surgery, Mount Sinai Hospital, Toronto, ON, Canada.
Sangeetha KalimuthuDivision of Pathology, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Rebecca WongDivision of Radiation Oncology, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada.
Patrick Veit-HaibachJoint Department of Medical Imaging, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Elena ElimovaDivision of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe incidence of esophageal and gastric carcinoma (GEC) in elderly patients is increasing, yet patients ≥75 years have historically been underrepresented in clinical trials. We sought to investigate palliative chemotherapy administration patterns and survival outcomes in older adults. MATERIALS AND

methodsA retrospective analysis identified patients aged 65-74 (young-old) and ≥75 years (older-old) diagnosed with advanced GEC. Patient and tumor characteristics were recorded, with descriptive analysis, time-to-event data analysis using Kaplan-Meier curves and multivariate Cox proportional hazards regression analysis performed.

resultsOne hundred and ninety-eight "young-old" and 109 'older-old' patients were identified. Patient characteristics were similar between groups except for Charlson Co-morbidity Index (CCI), with lower co-morbidities in the "young-old" compared to "older-old" cohort (P < .001; CCI = 0 in 103 (52%) "young-old" vs 31 (28%) "older-old"). The primary diagnosis in both groups was adenocarcinoma. 119 (60%) "young-old" and 25 (23%) "older-old" patients received chemotherapy (P < .001). Performance status was the primary explanation for chemotherapy non-receipt in both cohorts; age was the explanation in 21 (25%) "older-old" patients and none in the "young-old" patients. PFS for first-line systemic therapy in "young-old" patients was 6.4 (95% CI 5.9-7.6) versus 7.5 months (95% CI 5.1-11.3) in "older-old" patients (P = .69) whilst respective OS was 12.3 (95% CI 10.1-15.5) and 10.4 months (95% CI 9.0-14.6) (P = .0816). Toxicity prompted chemotherapy cessation in 17 (15%) "young-old" and 3 (13%) "older-old" patients (P = .97). Multivariate analysis identified CCI and ECOG performance status as predictive for PFS and OS, respectively. No causative relationship was identified with other variables.

conclusionOur study of real-world older-adults show that significant number of "older-old" patients with GEC do not receive chemotherapy. Among "older-old" adults who do receive systemic therapy, outcomes are comparable; this underscores the importance of geriatric assessment-guided care and suggests that age alone should not be a barrier to receipt of chemotherapy in patients with advanced GEC.

Indexed as

Esophageal NeoplasmsPalliative CareStomach NeoplasmsAgedAged, 80 and overAge FactorsAntineoplastic Combined Chemotherapy ProtocolsFemaleHumansMaleNeoplasm MetastasisRetrospective StudiesTreatment Outcomeesophageal cancergastric cancergeriatric oncologypalliative chemotherapy

Identifiers

PMID39046894
PMCPMC11546644

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.