Study on the survival prognosis of over 80 years old patients of esophageal cancer with other cancers-based on SEER data analysis

To explore the prognostic factors affecting over 80 years of age patients of esophageal cancer with other cancers through the SEER database and provide a scientific basis for the treatment of specific groups of esophageal cancer patients. A total of 2244 patients over 80 years of esophageal cancer with other cancers were selected from the SEER database. Through univariate and multivariate Cox regression analyses, variables were screened to determine independent prognostic risk factors for patients. Patients were divided into Group A and Group B according to sequence number. Propensity score matching (PSM) was performed to adjust for baseline differences between the two groups. Cancer-specific survival (CSS) and overall survival (OS) was calculated using the Kaplan-Meier method and compared using the log-rank test. Subgroup and Multiple Imputation analyses were conducted. This study included 2244 patients over 80 years old of esophageal cancer with other cancers. Cox multivariate analysis revealed that sequence number of primary tumours, surgery and chemotherapy were independent factors for CSS and OS. Age and T stage were an independent prognostic factor for OS but not CSS. Patients were divided into Group A (1st of 2 or more primaries patients) and Group B (2nd of 2 or more primaries, 3rd of 3 or more primaries and ≥ 4th or more primaries patients). There were significant differences in the baseline characteristic of two groups, we performed PSM analyses at a 1:1 ratio to erase significant difference of each variable. After PSM, the median CSS of Group A (31 months, 95% CI 23-47) was significantly better than that of Group B (13 months, 95% CI 10-17) (P < 0.05), the median OS of Group A (19 months, 95% CI 14-25) was significantly better than that of Group B (10 months, 95% CI 7-12) (P < 0.05). Death analysis of 2244 patients revealed that 74.51% (n = 1558) died from disease progression, 8.27% (n = 173) from other malignant tumours, 12.82% (n = 268) from non-tumour diseases, and 4.40% (n = 92) from other causes. Age, T stage, sequence number of primary tumours, surgery and chemotherapy were independent factors affecting the survival of over 80 years of age patients of esophageal cancer with other cancers. Esophageal cancer as the first primary cancer demonstrating markedly better prognosis compared to those with non-first primary esophageal cancers, especially for patients with aged 80-84 years and T1 stage independent of treatments. This study highlight the value of prognosis for over 80 years patients of esophageal cancer with other cancers. Further research is needed to explore the prognostic prediction and treatment.