Esophageal cancer in the elderly: an analysis of the factors associated with treatment decisions and outcomes

<p>Abstract</p> <p>Background</p> <p>Only limited data has been reported so far regarding oesophageal cancer (EC) in elderly patients. The aim of the study is to identify the baseline parameters that influenced therapeutic decision.</p> <p>Methods</p> <p>All consecutive patients 70 years or older being treated for EC were retrospectively analyzed. Patients without visceral metastasis were divided into two groups: treatment with curative intent (chemoradiotherapy, surgery, radiotherapy, mucosectomy or photodynamic therapy) or best supportive care (BSC). Patients with metastasis were divided into two groups: palliative treatment (chemotherapy, chemoradiotherapy or radiotherapy) or BSC.</p> <p>Results</p> <p>Two hundred and eighty-two patients were studied. Mean age was 76.5 ± 5.5 years and 22.4% of patients had visceral metastasis. In patients without visceral metastasis (n = 220) the majority had treatment with curative intent (n = 151) whereas in patients with metastasis (n = 62) the majority had BSC (n = 32). Severe adverse events (≥ grade 3) were observed in only 17% of the patients. Patients without specific carcinologic treatment were older, had more weight loss, worse WHO performance status and Charlson score in multivariate analysis.</p> <p>Discussion</p> <p>Our results suggest that elderly patients with an EC could benefit from cancer treatment without major toxicities. Weight loss, WHO performance status and the Charlson score could be used to select the appropriate treatment in an elderly patient.</p

What Is The Ability Emotional Intelligence Test (MSCEIT) Good For? An evaluation using Item Response Theory

The ability approach has been indicated as promising for advancing research in emotional intelligence (EI). However, there is scarcity of tests measuring EI as a form of intelligence. The Mayer Salovey Caruso Emotional Intelligence Test, or MSCEIT, is among the few available and the most widespread measure of EI as an ability. This implies that conclusions about the value of EI as a meaningful construct and about its utility in predicting various outcomes mainly rely on the properties of this test. We tested whether individuals who have the highest probability of choosing the most correct response on any item of the test are also those who have the strongest EI ability. Results showed that this is not the case for most items: The answer indicated by experts as the most correct in several cases was not associated with the highest ability; furthermore, items appeared too easy to challenge individuals high in EI. Overall results suggest that the MSCEIT is best suited to discriminate persons at the low end of the trait. Results are discussed in light of applied and theoretical considerations

Fully versus partially covered self-expandable metal stents in benign esophageal strictures

International audienc

Double stenting of oesophagus and airways in palliative treatment of patients with oesophageal cancer is efficient but associated with a high morbidity.

International audienceBACKGROUND: Double stenting of oesophagus and airways may be required in palliative treatment of patients with locally advanced oesophageal cancer. AIM: To assess feasibility, efficacy and complications occurring in patients with locally advanced oesophageal cancer receiving both oesophagus and airways stenting. METHODS: In one single centre between 1997 and 2005, among 180 patients with locally advanced oesophageal cancer treated by the palliative placement of a self-expanding metal stent, patients requiring double stenting of oesophagus and airways were identified. Clinical efficacy, complications and survival were retrospectively collected. RESULTS: Fifteen patients (8.3% of 180) required a double stenting at follow-up. Symptomatic efficacy of oesophagus and airways stenting was 86.7% for dysphagia and 100% for dyspnoea. Median survival after the second stent insertion was 99 days. Life-threatening early complications occurred in three patients after double stenting (20%), including two deaths following oesophageal perforation and massive haemoptysis, respectively. Procedure-related mortality was 13.3%. CONCLUSIONS: Double stenting of oesophagus and airways is feasible in patients with locally advanced oesophageal cancer, with a relevant clinical efficacy. However, early major complications including procedure-related death may occur in as many as 20% of patients. This treatment should be reserved to very selected patients with severe symptoms and end-stage disease