Improved Survival After Surgery for Esophageal Cancer

Improved Survival After Surgery for Esophageal Cancer

Survival after surgery for esophageal cancer improved significantly between 1987 and 2000, according to the results of a study published in the journal Lancet Oncology .

Cancer of the esophagus (the tube leading to the stomach) is relatively uncommon, but is one of the most aggressive and deadly of all cancers. According to the American Cancer Society, approximately 14,520 individuals in the U.S. will be diagnosed with esophageal cancer in 2005, and 13,570 will die of the disease.

The most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma. These types of disease are named for the cells within the esophagus where the cancer develops. Esophageal cancer is more common among men, African-Americans, smokers, heavy users of alcohol, and patients with Barrett’s esophagus. Currently, surgery is the only potentially curative treatment.

In order to assess changes in survival after surgery for esophageal cancer, researchers in Sweden evaluated information from nationwide cancer and mortality registries. Between 1987 and 2000, a total of 4904 patients were diagnosed with esophageal cancer. Of these, 764 were treated with surgery alone and were eligible for the study. For these patients, information about tumor stage, location, and type was collected from pathology reports.

Between 1987 and 2000, there were improvements in both short- and long-term survival:

  • The proportion of patients dying within 30 days of surgery decreased from 10% in 1987-1991 to 5% in 1997-2000.
  • One-year survival increased from 47% in 1987-1991 to 62% in 1997-2000.
  • Five-year survival increased from 20% in 1987-1991 to 31% in 1997-2000.
  • The improvements in survival after surgery were not explained by changes in age, tumor stage, or presence of other serious health problems.
  • Throughout the time period evaluated, survival after surgery was better among women, patients with stage 0 or I cancer, and patients with fewer other serious health problems.

The researchers conclude that the improved survival after surgery is not explained by changes in patient or tumor characteristics and most likely reflects improvements in surgery.

Reference: Rouvelas I, Zeng W, Lindblad M et al. Survival After Surgery for Oesophageal Cancer: A Population-Based Study. Lancet Oncology. 2005;6:864-70.

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