ABSTRACT
INTRODUCTION: Neoadjuvant chemotherapy (neoCTx) improves the prognosis of patients with localised oesophagogastric adenocarcinoma (EGC), but its value is unknown in elderly patients. PATIENTS AND METHODS: Patients who received neoCTx followed by surgery for EGC between 2000 and 2012 were analysed. The aim of this study was to compare the feasibility and outcome between patients aged ⩾70 (cohort I) and their younger counterparts (cohort II). RESULTS: Data were available for 460 patients among which 174 (38%) were ⩾70 years. Older age was associated with an increased rate of comorbidities (66% versus 42%, p<0,001). As compared to the younger, elderly patients were more likely to receive doublet instead of triplet neoCTx (65% versus 37%, p<0.001) and oxaliplatin-instead of cisplatin-based regimens (60% versus 32%, p<0.001). No significant difference was observed in the rate of ⩾grade 3 toxicities for cohort I and II (48% versus 41%) and postoperative morbidity was also not different (24% versus 28%). 90 day mortality for cohort I and II was 6.5% and 3.9%. After a median follow-up of 38 months, median disease-free survival (DFS) was 29.4 months in cohort I and 33.8 months in cohort II, with a 5-years DFS of 37% and 40%, respectively. Median overall survival (OS) was not reached in cohort I and was 58.4 months in cohort II, with a 5-year OS of 51% and 50% for cohort I and II, respectively. DISCUSSION: Despite slightly more adverse events and dose reductions, neoCTx is feasible in elderly patients with EGC. Elderly patients achieve comparable survival outcomes compared with their younger counterparts.
