Survival Status of Esophageal Cancer Patients and its Determinants in Ethiopia: A Facility Based Retrospective Cohort Study

Abstract

BackgroundGlobally, the incidence and mortality due to esophageal cancer are increasing, particularly in low- and middle-income countries. Cancer of the esophagus is the eighth in incidence and seventh in cancer mortality in Ethiopia. A few studies have shown an increasing burden, however, little is known about the survival pattern and its determinants among esophageal cancer patients in Ethiopia. Therefore, we assessed the survival pattern and its determinants among esophageal cancer patients.MethodsWe conducted a retrospective cohort study among 349 esophageal cancer patients who were diagnosed at or referred to Tikur Anbessa Specialized Hospital, Ethiopia from January 2010 to May 2017. Using an abstraction form, nurses who were working at the oncology department extracted the data from patient charts. To estimate and compare the probability of survival among covariate categories, we performed a Kaplan–Meier survival analysis with the log-rank test. To identify the prognostic determinants of survival, we performed a multivariable Cox proportional regression analysis.ResultsThe median follow-up time was 32 months with interquartile range of 15 to 42. Overall, the median survival time after diagnosis with esophageal cancer was 4 months with one-, two- and three-year survival of 14.4, 6.3, and 2.4% respectively. In the multivariable Cox proportional hazards model, receiving chemotherapy [Adjusted Hazard Ratio (AHR)=0.36, 95%CI: 0.27–0.49], radiotherapy [AHR=0.38, 95%CI: 0.23–0.63] and surgery [AHR=0.70, 95%CI: 0.54–0.89] were statistically significant.ConclusionsIn Ethiopia, esophageal cancer patients have a very low one-, two- and three-year survival. Despite a very low overall survival, patients who received either chemotherapy, radiotherapy or surgery showed a better survival compared with those who did not receive any treatment. Hence, it is essential to improve the survival of patients with esophageal cancer through early detection and timely initiation of the available treatment options.

Data on histological characteristics, survival patterns and determinants of mortality among colorectal, esophageal and prostate cancer patients in Ethiopia

“…Furthermore, Cox's proportional hazards regressions were performed to investigate the survival pattern and determinants of cancer-specific mortality among colorectal, esophageal and prostate cancer patients. Detailed results including Kaplan-Meier survival curves are available elsewhere [2] , [3] , [4] . We also performed a life table analysis for each cancer within five months of interval and the results are summarized in this article.…”

“…To comply with the ethical standards, identifiers such as name, medical registration number, physical address and telephone numbers are excluded from the datasets. Details of the analyzed data including sociodemographic characteristics, survival curves, and determinants of mortality among colorectal, esophageal and prostate cancer patients are available elsewhere [2] , [3] , [4] . Life table analyzes were computed for each cancer and the results are presented in this paper.…”

Determinants of survival outcomes among esophageal cancer patients at a national referral hospital in Kenya

“…Patients who underwent esophagectomy, radiotherapy, or chemoradiation had no differences in mean survival estimates compared to their counterparts. In contrast, an Ethiopian study revealed a better survival outcome, although most patients had low overall survival 35 . In addition, a previous study shows a relatively low overall rate of survival, although surgically treated patients had a significant improvement in survival outcomes 40 .…”

“…In contrast, an Ethiopian study revealed a better survival outcome, although most patients had low overall survival. 35 In addition, a previous study shows a F I G U R E 2 Kaplan-Meier survival curve of esophageal cancer patients with comorbidities and distant metastasis DETERMINANTS OF SURVIVAL OUTCOMES relatively low overall rate of survival, although surgically treated patients had a significant improvement in survival outcomes. 40 In our setting, chemotherapytreated patients had the longest duration of mean survival estimates compared to other treatment modalities suggesting possible priorities in eligible esophageal cancer patients.…”

Esophageal and Head and Neck Cancer Patients Attending Ocean Road Cancer Institute in Tanzania from 2019 to 2021: An Observational Study

“…Esophageal cancer is the seventh most common cancer globally, with more than 500,000 cases annually contributing to over 500,000 cancer deaths per year [ 22 ]. Esophageal cancer incidence and mortality are increasing in developing countries [ 23 , 24 ]. On the African continent, both the South and East have high numbers of cases and mortality [ 25 ].…”