Trends in survival based on treatment modality for esophageal cancer: a population-based study

Abstract

Objectives The primary objective was to examine the trends in treatment modalities and the respective survival rates for esophageal cancer in the province of Ontario, Canada. Methods This is a population-based study of all esophageal cancer cases diagnosed in Ontario between 2007 and 2015, including squamous cell carcinoma and adenocarcinoma, with known disease stage. Other characteristics include sex, age, date of diagnosis, and treatment modalities. Treatment modalities were classified as no-treatment, radiation only or chemotherapy only, chemoradiation, and surgical resection. Results In total, 2572 patients were identified with esophageal cancer from 2007 to 2015, of which 2014 (78.3%) were male. The mean age at diagnosis was 66.6 (SD = 11.7) years. Survival rate increased over time in patients who underwent chemoradiation or surgical resection but remained unchanged for the radiation-only or chemotherapy-only group and decreased for the no-treatment group. Survival considerably improved (15–20%) for patients with stages I–III disease. Conclusions The positive trends in the survival rate for esophageal patients could be due to adoption of multimodal therapy. Despite a lower proportion of advanced disease among patients over 80, they received less curative treatments compared with other age groups. Further studies are required to identify strategies to maximize survival for patients with stage IV disease, and patients 80 years and older.

The association between mortality and use of Chinese herbal medicine among incident stage IV esophageal cancer patients: A retrospective cohort study with core herbs exploration

“…The rate of OS shown in this study is comparable to previous studies, and this result suggests the reliability of using CGRD as the study material (Cheng et al, 2018;Akhtar-Danesh et al, 2019;He et al, 2020;Jung et al, 2020;Watanabe et al, 2021). Also, since guidelines recommend management based on multiple modalities for EC, the improvement in OS among CHM users provides the potential for using CHM as part of the management modalities for stage IV EC patients (Kitagawa et al, 2019;Muro et al, 2019).…”

“…Also, since guidelines recommend management based on multiple modalities for EC, the improvement in OS among CHM users provides the potential for using CHM as part of the management modalities for stage IV EC patients ( Kitagawa et al, 2019 ; Muro et al, 2019 ). Akhtar-Danesh et al (2019) reported that the 5-year OS rate of stage IV EC patients was 0.8% with chemotherapy or radiotherapy alone, 5% with chemoradiotherapy, and 19.7% with surgical resection. A much better 5-year OS rate of stage IV EC was reported in Japan: 17.2% with definitive chemoradiotherapy and12.9% with radiotherapy alone ( Watanabe et al, 2021 ).…”

Trends in conditional overall survival of esophageal cancer: a population-based study

“…In contrast, for patients who underwent surgery, the 5-year overall survival rate significantly increased with an estimated cure rate ranging from 25% to 73%, depending on the tumor stage. Similar conclusions were also observed in the nationwide Swedish cohort study (36) and the populationbased study in Ontario, Canada (37). Ethnic disparities in EC-related survival were also reported, in which black patients with ESCC were found to have a poor prognosis in comparison with white and Asian/Pacific Islander race patients, even though these disparities decreased over time (38).…”

Time to Surgery for Patients with Esophageal Cancer Undergoing Trimodal Therapy in Ontario: A Population-Based Cross-Sectional Study

“…Almost half of all patients with esophageal cancer in North America present with a disease that is unresectable [ 1 , 2 ]. For the remaining 50%, the time to surgery (TTS) is of the utmost importance.…”