Abstract 3273: Analysis of causes of death in patients with esophageal squamous cell carcinoma in China

Abstract

In China, more than 80% of the esophageal cancer occurs in farmer village, and most of the esophageal cancer patients die at village home. Therefore, the cause of death for esophageal cancer patients has not been well characterized. The present study was thus undertaken to determine the causes of death in patients with esophageal squamous cell carcinoma (ESCC) to provide more information for further prevention and accurate treatment after ESCC diagnosed. All the 8,838 ESCC patients with a detailed cause of death in this study were derived from the ESCC database (1973-2015) in Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, China. All the patients were categorized by age (<50 years and≥50 years), gender (male and female) and pathological stage (early, middle and later stage). Chi-Square test was used to analyze the differences in different groups. The results demonstrated that, of the 8,838 died ESCC patients, there were 5,713 males (64.6%) with a mean age of 60.95±9.43 and 3,125 females (35.4%) with a mean age of 61.95±9.47. Notably, 69.5% of the patients died within five years after diagnosis, and the 1-, 3- and 5-year death after diagnosis for these died ESCC patients were 1622 (18.4%), 2960 (33.5%) and 1557 (17.6%), respectively. Overall, the major cause of death for ESCC was due to ESCC recurrence and metastasis (8500, 96.1%), and followed by cardiovascular disease (121, 1.4%), different infections (68, 0.8%), second cancer (52, 0.6%), accident (25, 0.3%), suicide (22, 0.2%), and uncertain cause (50, 0.6%). Furthermore, the major cause of death in males and females was similar (p>0.05) and the cause of death by ESCC recurrence and metastasis, cardiovascular disease, different infections, second cancer, accident, suicide and uncertain cause was 96% (5485) 1.5% (84), 0.8% (44), 0.6% (34), 0.3% (18), 0.2% (16), 0.6% (32), respectively in males and 96.5% (3015), 1.1% (37), 0.8% (24) 0.6% (18), 0.2% (7), 0.2% (6) and 0.6% (18), respectively in females. The present results demonstrate that recurrence and metastasis are the major cause of death both in male and female for ESCC (96%). It is noteworthy that there are 0.2 percent of the ESCC patients have suicide which call for more attention of psychotherapy on cancer patients. [Supported by the Science and Technology Major Projects of Henan Province of China (161100311300), and Correspondence to: Li Dong Wang, the National Key Research and Development Program of China and Correspondence to: Li Dong Wang. Email: ldwang2007@126.com] Note: This abstract was not presented at the meeting. Citation Format: Xiang Yang Zhang, Jian Po Wang, Rui Ping Xu, Ya Qin Hou, Xiu Jian Chen, Ai Li Li, Xi Chen, Shuang Yin Han, Wei Xing Zhao, Li Sun, Min Wang, Wen Ting Fu, Li Dong Wang. Analysis of causes of death in patients with esophageal squamous cell carcinoma in China [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3273. doi:10.1158/1538-7445.AM2017-3273

Information disclosure to cancer patients in Mainland China: A meta‐analysis

“…Patients' actual awareness of diagnosis and prognosis was measured in 14 studies 19,31,32,34,35,39,43–50 . According to the meta‐analyses, the pooled proportions of diagnosis awareness and prognosis awareness were 59.3% (10 studies, N = 30,225, 95% CI [49.6%, 68.3%], I 2 = 0.971) and 19.9% (4 studies, N = 548, 95% CI [8.7%, 39.3%], I 2 = 0.946), respectively (Table 4).…”

“…In addition, patients' preferences and healthcare professionals' attitudes were never directly tested as predictors of patient awareness. Meanwhile, a series of predictors were only discussed by one study, such as cancer patients' income, 32 occupation, 44 religiousness, 46 length of hospital stay, 46 and family history of cancer, 34 which could not be included in the meta‐analysis. Moreover, few studies focussed on patients' prognosis awareness and how cancer type, clinical stage, or complications influence patients' diagnosis awareness, which could also have impeded the power of the meta‐analysis.…”

“…Seven studies explored predictors of patients' diagnosis awareness, 32,34,44,46,[48][49][50] while no study explored predictors of prognosis awareness.…”

“…Patients' actual awareness of diagnosis and prognosis was measured in 14 studies. 19,31,32,34,35,39,[43][44][45][46][47][48][49][50]…”

Differences in practice and preferences associated with truth-telling to cancer patients

“…Previous research showed that patients could guess their diagnoses by considering their symptoms, along with the information retrieved from the Internet. 9,16,17 During their efforts to figure out the truth, patients reported poor daily well-being, 18 more psychological morbidity and reduced trust in their families and the medical staff. 19 Concerning these negative effects, not telling the truth to patients with cancer is inappropriate for patients who want to be informed.…”