Treatment selection for esophageal cancer: evaluation from a nationwide database

Yasuo Hamamoto, Naoki Sakakibara, Fumio Nagashima, Yuukou Kitagawa, Takahiro Higashi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Most elderly patients poorly tolerate the standard treatment for esophageal cancer; however, little information is available regarding the appropriateness of non-standard esophageal cancer treatments for those patients. This study aims to analyze the treatment costs and completion rates of patients undergoing a real-world treatment for esophageal cancer to elucidate the treatment selection and its quality. Materials and methods: We analyzed treatment costs and completion rates for patients with esophageal cancer and analyzed these data relative to patient age and center volumes. Patients with esophageal cancer [UICC, TMN, Clinical stage II/III (excluding T4)] who were diagnosed in 2013 were analyzed. Patients were classified into five groups defined as follows: surgical therapy, chemotherapy, concurrent chemoradiotherapy (CCRT), modified concurrent chemoradiotherapy (mCRT), and radiotherapy (RT). Results: Mean and median age of patients who received surgery and CCRT were comparable; however, patients who underwent mCRT and RT tended to be older. Medical costs associated with surgery were higher than costs associated with other non-surgical treatments. Cost and completion rate of chemoradiotherapy did not differ between CCRT and mCRT; however, both had higher completion rates compared to that of RT. Surgical expenses tended to be the highest in low-volume centers and the lowest in high-volume centers. Conclusion: Treatment of esophageal cancer at high-volume centers seems well balanced compared with medium- to low-volume centers. mCRT was widely performed and comparable in medical cost to CCRT, although additional clinical impacts were unclear.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalEsophagus
DOIs
Publication statusAccepted/In press - 2018 Feb 20

Fingerprint

Chemoradiotherapy
Esophageal Neoplasms
Databases
Costs and Cost Analysis
Radiotherapy
Therapeutics
Health Care Costs
Drug Therapy

Keywords

  • Chemoradiotherapy
  • Costs of care
  • Elderly
  • Esophageal cancer
  • Hospital-based cancer registries

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Treatment selection for esophageal cancer : evaluation from a nationwide database. / Hamamoto, Yasuo; Sakakibara, Naoki; Nagashima, Fumio; Kitagawa, Yuukou; Higashi, Takahiro.

In: Esophagus, 20.02.2018, p. 1-6.

Research output: Contribution to journalArticle

Hamamoto, Yasuo ; Sakakibara, Naoki ; Nagashima, Fumio ; Kitagawa, Yuukou ; Higashi, Takahiro. / Treatment selection for esophageal cancer : evaluation from a nationwide database. In: Esophagus. 2018 ; pp. 1-6.
@article{b401f47cfd754fe1b856deea61ed17e7,
title = "Treatment selection for esophageal cancer: evaluation from a nationwide database",
abstract = "Background: Most elderly patients poorly tolerate the standard treatment for esophageal cancer; however, little information is available regarding the appropriateness of non-standard esophageal cancer treatments for those patients. This study aims to analyze the treatment costs and completion rates of patients undergoing a real-world treatment for esophageal cancer to elucidate the treatment selection and its quality. Materials and methods: We analyzed treatment costs and completion rates for patients with esophageal cancer and analyzed these data relative to patient age and center volumes. Patients with esophageal cancer [UICC, TMN, Clinical stage II/III (excluding T4)] who were diagnosed in 2013 were analyzed. Patients were classified into five groups defined as follows: surgical therapy, chemotherapy, concurrent chemoradiotherapy (CCRT), modified concurrent chemoradiotherapy (mCRT), and radiotherapy (RT). Results: Mean and median age of patients who received surgery and CCRT were comparable; however, patients who underwent mCRT and RT tended to be older. Medical costs associated with surgery were higher than costs associated with other non-surgical treatments. Cost and completion rate of chemoradiotherapy did not differ between CCRT and mCRT; however, both had higher completion rates compared to that of RT. Surgical expenses tended to be the highest in low-volume centers and the lowest in high-volume centers. Conclusion: Treatment of esophageal cancer at high-volume centers seems well balanced compared with medium- to low-volume centers. mCRT was widely performed and comparable in medical cost to CCRT, although additional clinical impacts were unclear.",
keywords = "Chemoradiotherapy, Costs of care, Elderly, Esophageal cancer, Hospital-based cancer registries",
author = "Yasuo Hamamoto and Naoki Sakakibara and Fumio Nagashima and Yuukou Kitagawa and Takahiro Higashi",
year = "2018",
month = "2",
day = "20",
doi = "10.1007/s10388-018-0605-0",
language = "English",
pages = "1--6",
journal = "Esophagus",
issn = "1612-9059",
publisher = "Springer Japan",

}

TY - JOUR

T1 - Treatment selection for esophageal cancer

T2 - evaluation from a nationwide database

AU - Hamamoto, Yasuo

AU - Sakakibara, Naoki

AU - Nagashima, Fumio

AU - Kitagawa, Yuukou

AU - Higashi, Takahiro

PY - 2018/2/20

Y1 - 2018/2/20

N2 - Background: Most elderly patients poorly tolerate the standard treatment for esophageal cancer; however, little information is available regarding the appropriateness of non-standard esophageal cancer treatments for those patients. This study aims to analyze the treatment costs and completion rates of patients undergoing a real-world treatment for esophageal cancer to elucidate the treatment selection and its quality. Materials and methods: We analyzed treatment costs and completion rates for patients with esophageal cancer and analyzed these data relative to patient age and center volumes. Patients with esophageal cancer [UICC, TMN, Clinical stage II/III (excluding T4)] who were diagnosed in 2013 were analyzed. Patients were classified into five groups defined as follows: surgical therapy, chemotherapy, concurrent chemoradiotherapy (CCRT), modified concurrent chemoradiotherapy (mCRT), and radiotherapy (RT). Results: Mean and median age of patients who received surgery and CCRT were comparable; however, patients who underwent mCRT and RT tended to be older. Medical costs associated with surgery were higher than costs associated with other non-surgical treatments. Cost and completion rate of chemoradiotherapy did not differ between CCRT and mCRT; however, both had higher completion rates compared to that of RT. Surgical expenses tended to be the highest in low-volume centers and the lowest in high-volume centers. Conclusion: Treatment of esophageal cancer at high-volume centers seems well balanced compared with medium- to low-volume centers. mCRT was widely performed and comparable in medical cost to CCRT, although additional clinical impacts were unclear.

AB - Background: Most elderly patients poorly tolerate the standard treatment for esophageal cancer; however, little information is available regarding the appropriateness of non-standard esophageal cancer treatments for those patients. This study aims to analyze the treatment costs and completion rates of patients undergoing a real-world treatment for esophageal cancer to elucidate the treatment selection and its quality. Materials and methods: We analyzed treatment costs and completion rates for patients with esophageal cancer and analyzed these data relative to patient age and center volumes. Patients with esophageal cancer [UICC, TMN, Clinical stage II/III (excluding T4)] who were diagnosed in 2013 were analyzed. Patients were classified into five groups defined as follows: surgical therapy, chemotherapy, concurrent chemoradiotherapy (CCRT), modified concurrent chemoradiotherapy (mCRT), and radiotherapy (RT). Results: Mean and median age of patients who received surgery and CCRT were comparable; however, patients who underwent mCRT and RT tended to be older. Medical costs associated with surgery were higher than costs associated with other non-surgical treatments. Cost and completion rate of chemoradiotherapy did not differ between CCRT and mCRT; however, both had higher completion rates compared to that of RT. Surgical expenses tended to be the highest in low-volume centers and the lowest in high-volume centers. Conclusion: Treatment of esophageal cancer at high-volume centers seems well balanced compared with medium- to low-volume centers. mCRT was widely performed and comparable in medical cost to CCRT, although additional clinical impacts were unclear.

KW - Chemoradiotherapy

KW - Costs of care

KW - Elderly

KW - Esophageal cancer

KW - Hospital-based cancer registries

UR - http://www.scopus.com/inward/record.url?scp=85042226084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042226084&partnerID=8YFLogxK

U2 - 10.1007/s10388-018-0605-0

DO - 10.1007/s10388-018-0605-0

M3 - Article

C2 - 29892936

AN - SCOPUS:85042226084

SP - 1

EP - 6

JO - Esophagus

JF - Esophagus

SN - 1612-9059

ER -