Optimal treatment strategy for older patients with esophageal squamous cell carcinoma: A multicenter retrospective study

Sato,Yuta; Tanaka,Yoshihiro; Takaha,Ritsuki; Suetsugu,Tomonari; Asai,Ryuichi; Imai,Takeharu; Yamada,Makoto; Nagao,Narutoshi; Watanabe,Daichi; Matsuhashi,Nobuhisa

doi:10.3892/ol.2025.14905

Optimal treatment strategy for older patients with esophageal squamous cell carcinoma: A multicenter retrospective study

Authors:
- Yuta Sato
- Yoshihiro Tanaka
- Ritsuki Takaha
- Tomonari Suetsugu
- Ryuichi Asai
- Takeharu Imai
- Makoto Yamada
- Narutoshi Nagao
- Daichi Watanabe
- Nobuhisa Matsuhashi
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Affiliations: Department of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of Medicine, Gifu, Gifu 501‑1194, Japan, Department of Surgery, Gifu Prefectural General Hospital, Gifu, Gifu 500‑8717, Japan, Department of Surgery, Gifu Municipal Hospital, Gifu, Gifu 500‑8323, Japan, Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Gifu 501‑1194, Japan
Published online on: January 23, 2025 https://doi.org/10.3892/ol.2025.14905
Article Number: 159
Copyright: © Sato et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The appropriate treatment strategy for esophageal squamous cell carcinoma (ESCC) in older patients remains unclear. The efficacy of preoperative chemotherapy using a divided‑dose regimen of biweekly docetaxel, cisplatin and 5‑fluorouracil (DCF) neoadjuvant chemotherapy (NAC) was compared with upfront surgery (US) in patients aged ≥70 years with ESCC. The present study retrospectively analyzed the multicenter data of patients who received esophagectomy for ESCC between January 2015 and December 2021. The present study investigated patient prognosis using inverse probability weighting analysis and psoas muscle index (PMI) as a background factor for older patients with ESCC potentially deriving greater benefit from this NAC regimen. Among 86 eligible patients, 47 received NAC (NAC group) and 39 underwent US (US group). No significant differences were observed between the groups in 3‑year overall survival [OS; hazard ratio (HR), 0.576; P=0.325) and 3‑year recurrence‑free survival (HR, 0.483; P=0.141). Among the patients with low PMI, 3‑year OS was significantly prolonged in the NAC group vs. the US group (HR, 0.342; 95% CI, 0.144‑0.812; P=0.015). In the older patients with ESCC, a divided‑dose regimen of DCF did not improve prognosis. When the PMI is low, a biweekly DCF regimen may contribute to extending OS. Future prospective large studies are needed.

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