Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA.

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  • معلومة اضافية
    • Subject Terms:
    • Author-Supplied Keywords:
      Disparities in care
      Elderly
      Esophageal cancer
      Survival
      Treatment
    • NAICS/Industry Codes:
      923130 Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
    • Abstract:
      Objectives: Large numbers of elderly patients in the USA receive no treatment for esophageal cancer, despite evidence that multimodality treatment can increase survival. Our goal is to identify factors that may contribute to lack of treatment.Materials and Methods: Using Surveillance Epidemiology and End Results (SEER)-Medicare Linked Database (2001-2009), we identified regional esophageal cancer patients ≥65 years old. Treatment was defined as receiving any medical or surgical therapy for esophageal cancer. Logistic regression analysis was performed to identify factors associated with failure to receive treatment. Overall survival (OS) was analyzed using the Kaplan-Meier method and Cox proportional hazard model.Results: There were 5072 patients (median age, 75 years; interquartile range (IQR), 71-81 years). Majority were treated with definitive chemoradiation (48.49 %). Factors associated with lack of treatment included West geographic region and ≥80 years old. Patients who received therapy had better OS (log-rank, p < 0.001). Compared with treated patients, non-treated patients had worse adjusted OS (HR, 1.43; 95 % confidence interval (CI), 1.33-1.55; p < 0.001).Conclusions: Elderly patients with locally advanced esophageal cancer who received treatment had improved 5-year survival compared with patients without treatment. Disparities in utilization of treatment are associated with regional and socioeconomic factors, not presence of comorbidities. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Department of Surgery , Johns Hopkins University School of Medicine , Baltimore USA
      2Department of Oncology , Johns Hopkins University School of Medicine , Baltimore USA
      3Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
      4Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
      5Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave K4/752, Madison, WI, 53792-7375, USA
    • ISSN:
      1091-255X
    • Accession Number:
      10.1007/s11605-016-3229-5
    • Accession Number:
      120384480
  • Citations
    • ABNT:
      MOLENA, D. et al. Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA. Journal of Gastrointestinal Surgery, [s. l.], v. 21, n. 1, p. 126–136, 2017. DOI 10.1007/s11605-016-3229-5. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=120384480&custid=s8280428. Acesso em: 18 jan. 2020.
    • AMA:
      Molena D, Stem M, Blackford A, Lidor A, Blackford AL, Lidor AO. Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA. Journal of Gastrointestinal Surgery. 2017;21(1):126-136. doi:10.1007/s11605-016-3229-5.
    • APA:
      Molena, D., Stem, M., Blackford, A., Lidor, A., Blackford, A. L., & Lidor, A. O. (2017). Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA. Journal of Gastrointestinal Surgery, 21(1), 126–136. https://doi.org/10.1007/s11605-016-3229-5
    • Chicago/Turabian: Author-Date:
      Molena, Daniela, Miloslawa Stem, Amanda Blackford, Anne Lidor, Amanda L Blackford, and Anne O Lidor. 2017. “Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA.” Journal of Gastrointestinal Surgery 21 (1): 126–36. doi:10.1007/s11605-016-3229-5.
    • Harvard:
      Molena, D. et al. (2017) ‘Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA’, Journal of Gastrointestinal Surgery, 21(1), pp. 126–136. doi: 10.1007/s11605-016-3229-5.
    • Harvard: Australian:
      Molena, D, Stem, M, Blackford, A, Lidor, A, Blackford, AL & Lidor, AO 2017, ‘Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA’, Journal of Gastrointestinal Surgery, vol. 21, no. 1, pp. 126–136, viewed 18 January 2020, .
    • MLA:
      Molena, Daniela, et al. “Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA.” Journal of Gastrointestinal Surgery, vol. 21, no. 1, Jan. 2017, pp. 126–136. EBSCOhost, doi:10.1007/s11605-016-3229-5.
    • Chicago/Turabian: Humanities:
      Molena, Daniela, Miloslawa Stem, Amanda Blackford, Anne Lidor, Amanda L Blackford, and Anne O Lidor. “Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA.” Journal of Gastrointestinal Surgery 21, no. 1 (January 2017): 126–36. doi:10.1007/s11605-016-3229-5.
    • Vancouver/ICMJE:
      Molena D, Stem M, Blackford A, Lidor A, Blackford AL, Lidor AO. Esophageal Cancer Treatment Is Underutilized Among Elderly Patients in the USA. Journal of Gastrointestinal Surgery [Internet]. 2017 Jan [cited 2020 Jan 18];21(1):126–36. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=120384480&custid=s8280428