Determining Overall Survival and Risk Factors in Esophageal Cancer Using Censored Quantile Regression

Abstract

Background:Esophageal cancer is one of the leading causes of death worldwide. The global increasing rate of this type of cancer requires more attention. The purpose of this study was to determine the overall survival probability of esophageal cancer after diagnosis and to assess the potential risk factors in a population of Iranian patients.Materials and Methods:This retrospective cohort study was conducted on 127 cases with esophageal cancer in the Azarbaijan province, East of Iran. Participants in the study were diagnosed during 2009-2010 and were followed up for 5 years. The event was considered death due to esophageal cancer and those who survived until the end of the study were assumed as right censored. Censored quntile regression was fitted to find the overall survival of the patients using adjusted effects of variables and was compared with Cox regression model.Results:Patients’ mean and median survival time were 16.99 and 10.06 months respectively and 89% off cases died by the end of the study. The 1, 3, 6, 12 and 36-month survival probabilities were 0.95, 0.76, 0.60, 0.43, and 0.18. The median survival time for females and males without surgery were 21.79 and 14.76 month respectively. The accuracy of predictions were 0.99 and 0.74 for the censored quantile regression and Cox, respectively.Conclusion:We concluded that being male, not having surgery, longer wait time between having symptoms and being diagnosed, low socioeconomic status and old age to be significant risk factors in reducing the probability of survival from esophageal cancer.

Variation in Diagnosis, Treatment, and Outcome of Esophageal Cancer in a Regionalized Care System in Ontario, Canada

“…However, there is limited evidence that longer wait times are associated with worse survival. 15 , 16 , 17 , 18 , 19 The association of having a longer time until treatment with better overall survival has been demonstrated previously in patients with cancer and is likely due to a triaging effect. 14 , 20 Patients with more overt symptoms are more likely to have advanced disease and be diagnosed or treated urgently, which may only be partially accounted for by stage and is likely to confound any associations between wait times and survival.…”

Prognostic models for stage I–III esophageal cancer: a comparison between existing calculators

“…In addition to the stage of the disease, the response to therapy has also been reported to be strongly associated with survival rate (14)(15)(16). Nonetheless, these sole characteristics are not sufficient to estimate accurate prognosis for individual patients as multiple other patient-, tumor-and treatment-related factors are important predictors for OS (17,18).…”

Cardiac tamponade as an unusual initial presentation of squamous cell carcinoma of the esophagus

“…Patients with SCC are more likely to be asymptomatic until the advanced stage or the development of complications. On the other hand, patients with adenocarcinoma usually present earlier due to the mechanism of adenocarcinoma which evolved from premalignant lesions [10]. Moreover, SCC is a mass-forming type of cancer cell; it tends to be more locally invasive [2].…”