title: Multicenter questionnaire survey on patterns of care for elderly patients with esophageal squamous cell carcinoma by the Japan Esophageal Oncology Group.
abstract: OBJECTIVE
  There is little information about the patterns of care for elderly esophageal squamous cell carcinoma patients, and a standardized strategy has not been established. Therefore, we conducted a questionnaire survey about the patterns of care for these patients.
  
  
  METHODS
  On September 2014, the questionnaires were sent to all 43 institutions of the Japan Esophageal Oncology Group, which comprised five parts: (i) definition of 'elderly' (age, method), (ii) basic treatment strategy according to stage and elderly status (fit/vulnerable/frail), (iii) patterns of care in each stage, (iv) considerations about conducting future clinical trials and (v) other information about geriatric oncology concerning esophageal squamous cell carcinoma.
  
  
  RESULTS
  All answers were obtained by January 2015. Nearly half institutions (47%) considered the chronological definition of elderly to be over 80 years old. Among 43 institutions, 36 (84%) reported that the type of comorbidity and performance status were important factors for decision-making; no institution selected geriatric scale as an indicator. The most selected treatment strategy in fit healthy elderly patients was the same as the standard treatment of non-elderly patients. Radiation alone was considered the main treatment for vulnerable and frail esophageal squamous cell carcinoma patients. Most of the institutions answered that clinical trials for the elderly are warranted. Most institutions (70%) chose Stage II/III (non-T4) esophageal squamous cell carcinoma as an important investigational target.
  
  
  CONCLUSIONS
  Fit healthy elderly were considered the same as non-elderly patients, although there are no established treatment selection criteria. Radiation alone plays most important role in the treatment for vulnerable and frail esophageal squamous cell carcinoma patients. Stage II/III (non-T4) disease is attractive and warranted for future investigations.
authors.affiliation: Keio Cancer Center, Keio University Hospital, School of Medicine, Tokyo yhamamoto@z2.keio.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hamamoto
authors.affiliation: Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Akutsu
authors.affiliation: Department of Medical Oncology, Kyorin University School of Medicine, Tokyo.
authors.forename: Fumio
authors.initials: F
authors.lastname: Nagashima
authors.affiliation: Clinical Trial Promotion Department, Chiba Cancer Center, Chiba.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hironaka
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Gastrointestinal Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Ken
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Gastroenterology, Saitama Cancer Center Hospital, Saitama.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hara
authors.affiliation: Esophageal Surgical Division, Shizuoka Cancer Center, Shunto-gun.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsubosa
authors.affiliation: Department of Digestive Surgery, Niigata Cancer Center Hospital, Niigata.
authors.forename: Satoru
authors.initials: S
authors.lastname: Nakagawa
authors.affiliation: Department of Surgery, National Cancer Center Hospital East, Chiba.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daiko
authors.affiliation: Department of Gastroenterological Surgery, Tokai University School of Medicine, Kanagawa.
authors.forename: Soji
authors.initials: S
authors.lastname: Ozawa
authors.affiliation: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D004938:Esophageal Neoplasms; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D011795:Surveys and Questionnaires
keywords: elderly; esophageal squamous cell carcinoma; questionnaire