Social group disparities in the incidence and prognosis of oesophageal cancer

Xie, Shao-Hua; Lagergren, Jesper

doi:10.1177/2050640617751254

Cited by 33 publications

(27 citation statements)

References 48 publications

(124 reference statements)

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“…However, advancing age and socioeconomic deprivation was impaired to poorer OS in this study. A worse prognosis has been associated with black individuals with esophageal cancer, but this has not held true when adjusting for socioeconomic status, while blacks, Asians, and Hispanics have been shown to undergo lower rates of surgery, when compared to whites, in localized esophageal cancer[ 33 ]. In addition, there were more patients from the geographic Southern region who did not receive any palliative therapy (30.9%) compared to those who received palliative therapy (23.6%, P = 0.003), and notably being from the South was significantly associated with a worse OS on both univariate and multivariable analyses (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of palliative therapies in metastatic esophageal cancer patients not receiving chemotherapy

Kim¹,

DiPeri²,

Guan³

et al. 2020

WJGS

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BACKGROUND Palliative therapy has been associated with improved overall survival (OS) in several tumor types. Not all patients with metastatic esophageal cancer receive palliative chemotherapy, and the roles of other palliative therapies in these patients are limited. AIM To investigate the impact of other palliative therapies in patients with metastatic esophageal cancer not receiving chemotherapy. METHODS The National Cancer Database was used to identify patients between 2004-2015. Patients with M1 disease who declined chemotherapy and had known palliative therapy status [palliative therapies were defined as surgery, radiotherapy (RT), pain management, or any combination thereof] were included. Cases with unknown chemotherapy, RT, or nonprimary surgery status were excluded. Kaplan-Meier estimates of OS were calculated. Cox proportional hazards regression models were employed to examine factors influencing survival. RESULTS Among 140234 esophageal cancer cases, we identified 1493 patients who did not receive chemotherapy and had complete data. Median age was 70 years, most (66.3%) had a Charlson Comorbidity Index (CCI) of 0, and 37.1% were treated at an academic center. The majority (72.7%) did not receive other palliative therapies. On both univariate and multivariable analyses, there was no difference in OS between those receiving other palliative therapy (median 2.83 mo, 95%CI: 2.53-3.12) vs no palliative therapy (2.37 no, 95%CI: 2.2-2.56; multivariable P = 0.290). On univariate, but not multivariable analysis, treatment at an academic center was predictive of improved OS [Hazard ratio (HR) 0.90, 95%CI: 0.80-1.00; P = 0.047]. On multivariable analysis, female sex (HR 0.81, 95%CI: 0.71-0.92) and non-black, other race compared to white race (HR 0.72, 95%CI: 0.56-0.93) were associated with reduced mortality, while South geographic region relative to West region (HR 1.23, 95%CI: 1.04-1.46) and CCI of 1 relative to CCI of 0 (HR 1.17, 95%CI: 1.03-1.32) were associated with increased mortality. Higher histologic grade and T-stage were also associated with worse OS ( P < 0.05). CONCLUSION Palliative therapies other than chemotherapy conferred a numerically higher, but not statistically significant difference in OS among patients with metastatic esophageal cancer not receiving chemotherapy. Quality of life metrics, inpatient status, and subgroup analyses are important for examining the role of palliative therapies other than chemotherapy in metastatic esophageal cancer and future studies are warranted.

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Section: Discussionmentioning

confidence: 99%

Impact of palliative therapies in metastatic esophageal cancer patients not receiving chemotherapy

Kim¹,

DiPeri²,

Guan³

et al. 2020

WJGS

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“…More and more research is being directed at developing better treatment and improving prognosis for patients diagnosed with ESCC. Previous studies suggested that certain factors had an effect on the prognosis of ESCC patients however, the systematic analysis of these factors as a prognostic took has not been done [19][20][21][22][23][24]. In the present study, we have analyzed the ESCC patients' data from two academic institutes, SYSUCC and HNCH.…”

Section: Discussionmentioning

confidence: 98%

Establishment and Validation of a Prognostic Model in Patients with Stage T1-3N0M0 of Esophageal Squamous Cell Carcinoma (ESCC): An Observational Study from Two Centers

Wu¹,

Ji²,

Zheng³

et al. 2020

Preprint

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PURPOSE: To explore the postoperative prognosis of patients diagnosed with esophageal squamous cell carcinoma (ESCC) of stage T1-3N0M0 using a survival prognostic model (SPM). PATIENTS AND METHODS: Patients diagnosed with stage T1-3N0M0 ESCC from two cancer centers—Sun Yat-sen University Cancer Center (SYSUCC-A/ training cohort: N = 555), SYSUCC-B/ internal validation cohort: N = 241) and Henan Cancer Hospital (HNCH/ external validation cohort: N = 170)—that had undergone esophagectomy between 1995 and 2015 were enrolled in this study. The primary clinical endpoint was overall survival (OS). We have identified and integrated significant prognostic factors for OS by univariate and multivariate Cox regression methods applied in the training cohort to build a SPM that could be validated in the validation cohorts.RESULTS: The OS evaluation by the SPM was comparable in three cohorts (SYSUCC-A: C-index 0.654, SYSUCC-B: C-index 0.630, HNCH: C-index 0.688). Discretization of patients was done using a fixed survival score cutoff of 136.434 based on our SPM determined from the training cohort divided into low- and high-risk subgroups with stratified OS in the validation cohort (SYSUCC-A: hazard ratio [HR] 1.009, 95% confidence intervals [CI], 1.006–1.011, P < 0.001; SYSUCC-B: HR 1.009, 95% CI, 1.004–1.013, P ˂ 0.001; HNCH: HR 1.010, 95% CI 1.005-1.015, P = 0.0017). The 48-month OS in the low-risk subgroup vs. that in the high-risk subgroup was 80.8% vs. 60.9% for SYSUCC-A, 86.4% vs. 60.7% for SYSUCC-B, and 89.7% vs. 64.1% for HNCH. CONCLUSION: We have established and validated a novel SPM that can predict the OS for T1-3N0M0 ESCC patients and could help clinicians to detect subgroups of patients with poor prognosis.

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“…Besides, the majority of the patients were at advanced stages of cancer. Dysphagia and late presentations became the cardinal presentations of EC patients in Ethiopia (23,28,29), Africa (16,33,35,(40)(41)(42) and elsewhere (43)(44)(45)(46). The reason could be because of the fact that esophagus has a remarkable capability to stretch until signi cantly blocked by the tumor (47).In addition, presenting at a late stage of cancer with dysphagia could be linked to failure to understand the early symptoms associated with esophageal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Clinico-Pathological Findings and Spatial Distributions of Esophageal Cancer in Arsi Zone, Central Ethiopia

Deybasso

Roba

Nega

et al. 2020

Preprint

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Background: Arsi Zone is one of the esophageal cancer endemic areas and reported to have high incidence of esophageal cancer in Ethiopia. This study assessed clinico-pathological patterns and spatial distributions of esophageal cancer in Arsi Zone, Oromia, Central Ethiopia.Methods: A cross sectional study design was carried out by abstracting data from 403 patients` records that were treated from January 2015 to January 2019. Data were collected by using structured data collection form and Geographical Positioning System software. The collected data were summarized in the form of tables, figures, means and standard deviations. Statistical data analysis was done using SPSS software version 21.0 while geospatial analysis was conducted using the Arc-GIS 10.1 software.Results: The disease was prominent among individuals aged 50 to 59 years. The mean age of females and males was 52.2(SD+10.41) and 56.94(SD +12.27) years respectively. The vast majority (98.3%) of the cases had squamous cell carcinoma. Dysphagia with weight loss accounted for 87.6 percent of the presenting symptoms. The tumor was located at the lower thorax of 42.9% of the patients. Majority (62%) of the patients were from the eastern and north-eastern parts of the Arsi zone. Overwhelming majorities of the patients were from the Robe, Jaju, Disksis and Sude districts.Conclusion: Dysphagia with weight loss was the major symptom during first visit. Squamous cell carcinoma was the predominant histopathological type. Eastern and the northeastern parts of the Zone are the most affected regions. Future studies should focus on the determinants of EC and precise areas with high incidence by using prospective studies through the population and/or facility-based cancer registry systems

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Social group disparities in the incidence and prognosis of oesophageal cancer

Cited by 33 publications

References 48 publications

Impact of palliative therapies in metastatic esophageal cancer patients not receiving chemotherapy

Impact of palliative therapies in metastatic esophageal cancer patients not receiving chemotherapy

Establishment and Validation of a Prognostic Model in Patients with Stage T1-3N0M0 of Esophageal Squamous Cell Carcinoma (ESCC): An Observational Study from Two Centers

Clinico-Pathological Findings and Spatial Distributions of Esophageal Cancer in Arsi Zone, Central Ethiopia

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