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. 2018 May 10;8(5):e021495.
doi: 10.1136/bmjopen-2018-021495.

Prognosis of oesophageal adenocarcinoma and squamous cell carcinoma following surgery and no surgery in a nationwide Swedish cohort study

Joonas H Kauppila  1   2 , Fredrik Mattsson  1 , Nele Brusselaers  3 , Jesper Lagergren  1   4
Affiliations

Prognosis of oesophageal adenocarcinoma and squamous cell carcinoma following surgery and no surgery in a nationwide Swedish cohort study

Joonas H Kauppila et al. BMJ Open. .

Abstract

Objectives: To assess the recent prognostic trends in oesophageal adenocarcinoma and oesophageal squamous cell carcinoma undergoing resectional surgery and no such surgery. Additionally, risk factors for death were assessed in each of these patient groups.

Design: Cohort study.

Setting: A population-based, nationwide study in Sweden.

Participants: All patients diagnosed with oesophageal adenocarcinoma and oesophageal squamous cell carcinoma in Sweden from 1 January 1990 to 31 December 2013, with follow-up until 14 May 2017.

Outcome measures: Observed and relative (to the background population) 1-year , 3-year and 5-year survivals were analysed using life table method. Multivariable Cox regression provided HR with 95% CI for risk factors of death.

Results: Among 3794 patients with oesophageal adenocarcinoma and 4631 with oesophageal squamous cell carcinoma, 82% and 63% were men, respectively. From 1990-1994 to 2010-2013, the relative 5-year survival increased from 12% to 15% for oesophageal adenocarcinoma and from 9% to 12% for oesophageal squamous cell carcinoma. The corresponding survival following surgery increased from 27% to 45% in oesophageal adenocarcinoma and from 24% to 43% in oesophageal squamous cell carcinoma. In patients not undergoing surgery, the survival increased from 3% to 4% for oesophageal adenocarcinoma and from 3% to 6% for oesophageal squamous cell carcinoma. Women with oesophageal squamous cell carcinoma had better prognosis than men both following surgery (HR 0.71, 95% CI 0.61 to 0.83) and no surgery (HR 0.86, 95% CI 0.81 to 0.93).

Conclusions: The prognosis has improved over calendar time both in oesophageal adenocarcinoma and oesophageal squamous cell carcinoma in Sweden that did and did not undergo surgery. Women appear to have better prognosis in oesophageal squamous cell carcinoma than men, independent of treatment.

Keywords: epidemiology; gastrointestinal tumours; oesophageal disease; thoracic surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves showing observed 5-year survival oesophageal adenocarcinoma (A) stratified by surgical treatment (yes or no). Patients undergoing oesophageal resection for adenocarcinoma (B) and not undergoing oesophageal resection for adenocarcinoma (C) are further stratified by calendar periods.
Figure 2
Figure 2
Kaplan-Meier survival curves showing observed 5-year survival oesophageal squamous cell carcinoma (A) stratified by surgical treatment (yes or no). Patients undergoing oesophageal resection for squamous cell carcinoma (B) and not undergoing oesophageal resection for squamous cell carcinoma (C) are further stratified by calendar periods.
See this image and copyright information in PMC

References

    1. Fitzmaurice C, Allen C, Barber RM, et al. . Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2017;3:524–48. 10.1001/jamaoncol.2016.5688 - DOI - PMC - PubMed
    1. Gavin AT, Francisci S, Foschi R, et al. . Oesophageal cancer survival in Europe: a EUROCARE-4 study. Cancer Epidemiol 2012;36:505–12. 10.1016/j.canep.2012.07.009 - DOI - PubMed
    1. Dubecz A, Gall I, Solymosi N, et al. . Temporal trends in long-term survival and cure rates in esophageal cancer: a SEER database analysis. J Thorac Oncol 2012;7:443–7. 10.1097/JTO.0b013e3182397751 - DOI - PubMed
    1. Lagergren J, Mattsson F, Mattson F. Diverging trends in recent population-based survival rates in oesophageal and gastric cancer. PLoS One 2012;7:e41352 10.1371/journal.pone.0041352 - DOI - PMC - PubMed
    1. Napier KJ, Scheerer M, Misra S. Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities. World J Gastrointest Oncol 2014;6:112–20. 10.4251/wjgo.v6.i5.112 - DOI - PMC - PubMed

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