J Cancer 2023; 14(6):1039-1048. doi:10.7150/jca.83490 This issue Cite

Research Paper

Influence of age as a continuous variable on survival outcomes and treatment options in patients with upper thoracic esophageal carcinoma

Yu Lin1,*, Yuling Ye1,*, Qiuyuan Huang1, Binglin Zheng1, Yong Yang2, Yuanmei Chen3,✉, Weiguang Li1, Hongqian Ke1, Chuyan Lin1, Yiping Zhang1, Liyan Wang1, Junqiang Chen1,✉, Yuanji Xu1,✉

1. Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, China
2. Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou 350001, China
3. Department of Thoracic Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hosptial, Fuzhou 350014, China
* These authors contributed equally to this article.

Citation:
Lin Y, Ye Y, Huang Q, Zheng B, Yang Y, Chen Y, Li W, Ke H, Lin C, Zhang Y, Wang L, Chen J, Xu Y. Influence of age as a continuous variable on survival outcomes and treatment options in patients with upper thoracic esophageal carcinoma. J Cancer 2023; 14(6):1039-1048. doi:10.7150/jca.83490. https://www.jcancer.org/v14p1039.htm
Other styles

File import instruction

Abstract

Graphic abstract

Background: This retrospective review of patients with upper thoracic esophageal squamous cell carcinoma (ESCC) analyzed the prognostic value of age, as a continuous variable, and offered insight into treatment options.

Methods: 568 upper ESCC patients underwent radical therapy between 2004 and 2016. Age as a continuous variable was entered into the Cox regression model with penalized spline (P-spline) analysis to investigate a correlation between age and survival outcomes.

Results: Before adjustment, P-spline regression revealed U-shaped survival curves. Sixty years was the optimal cut-off age for differences in overall and progression-free survival (OS, PFS). The cohort was divided into age groups ≤ 50, 51-69, and ≥ 70 years. Multivariate analyses showed no significant differences in either PFS or OS for patients aged ≤ 50 and 51-69 years. After adjusting for covariates, P-spline regression showed that the risk of mortality and disease progression increased with age, and ≥ 70 years was an unfavorable independent prognostic factor. For age ≥ 70 years, the OS and PFS associated with non-surgery was comparable to that of surgery. For patients younger, the OS and PFS of patients given surgery was significantly better than that of patients given non-surgery.

Conclusion: Age was an independent prognostic factor for upper ESCC. Patients ≥ 70 years achieved no significant survival benefit from surgery, but for those younger than 70 years surgery was the preferred treatment option.

Keywords: upper ESCC, age, prognosis, treatment


Citation styles

APA
Lin, Y., Ye, Y., Huang, Q., Zheng, B., Yang, Y., Chen, Y., Li, W., Ke, H., Lin, C., Zhang, Y., Wang, L., Chen, J., Xu, Y. (2023). Influence of age as a continuous variable on survival outcomes and treatment options in patients with upper thoracic esophageal carcinoma. Journal of Cancer, 14(6), 1039-1048. https://doi.org/10.7150/jca.83490.

ACS
Lin, Y.; Ye, Y.; Huang, Q.; Zheng, B.; Yang, Y.; Chen, Y.; Li, W.; Ke, H.; Lin, C.; Zhang, Y.; Wang, L.; Chen, J.; Xu, Y. Influence of age as a continuous variable on survival outcomes and treatment options in patients with upper thoracic esophageal carcinoma. J. Cancer 2023, 14 (6), 1039-1048. DOI: 10.7150/jca.83490.

NLM
Lin Y, Ye Y, Huang Q, Zheng B, Yang Y, Chen Y, Li W, Ke H, Lin C, Zhang Y, Wang L, Chen J, Xu Y. Influence of age as a continuous variable on survival outcomes and treatment options in patients with upper thoracic esophageal carcinoma. J Cancer 2023; 14(6):1039-1048. doi:10.7150/jca.83490. https://www.jcancer.org/v14p1039.htm

CSE
Lin Y, Ye Y, Huang Q, Zheng B, Yang Y, Chen Y, Li W, Ke H, Lin C, Zhang Y, Wang L, Chen J, Xu Y. 2023. Influence of age as a continuous variable on survival outcomes and treatment options in patients with upper thoracic esophageal carcinoma. J Cancer. 14(6):1039-1048.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Popup Image