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Trends in treatment and overall survival among patients with proximal esophageal cancer

World Journal of Gastroenterology 2019年第47期25卷 6835-6846页

作者： Judith de Vos-Geelen Sandra ME Geurts Liselot BJ Valkenburg-van Iersel Evelien JM de Jong Vivianne CG Tjan-Heijnen Margreet van Putten Valery EPP Lemmens Heike I Grabsch Nadia Haj Mohammad Frank JP Hoebers Chantal V Hoge Paul M Jeene hanneke wm van laarhoven Tom Rozema Marije Slingerland Grard AP Nieuwenhuijzen Department of Internal Medicine Division of Medical OncologyGROW-School for Oncology and Developmental BiologyMaastricht University Medical CenterMaastricht 6202 AZNetherlands Department of Research Netherlands Comprehensive Cancer Organization(IKNL)Eindhoven 5612 HZNetherlands Department of Pathology GROW-School for Oncology and Developmental BiologyMaastricht University Medical CenterMaastricht 6202 AZNetherlands Pathology and Data Analytics Leeds Institute of Medical Research at St James”sUniversity of LeedsLeeds LS97TFUnited Kingdom Department of Medical Oncology University Medical Center UtrechtUtrecht 3584 CXNetherlands Department of Radiation Oncology(MAASTRO clinic) GROW-School for Oncology and Developmental BiologyMaastricht University Medical CenterMaastricht 6229 ETNetherlands Department of Internal Medicine Division of GastroenterologyMaastricht University Medical CenterMaastricht 6202 AZNetherlands Department of Radiotherapy RadiotherapiegroepDeventer 7416 SENetherlands Department of Medical Oncology Amsterdam University Medical CentersUniversity of AmsterdamAmsterdam 1105 AZNetherlands Department of Radiotherapy Insituut VerbeetenTilburg 5042 SBNetherlands Department of Medical Oncology Leiden University Medical CenterLeiden 2333 ZANetherlands Department of Surgery Catharina Hospital EindhovenEindhoven 5623 EJNetherlands Department of Public Health Erasmus Medical Center RotterdamRotterdam 3015 GDNetherlands

BACKGROUND The management of proximal esophageal cancer differs from that of tumors located in the mid and lower part of the esophagus due to the close vicinity of vital ***-surgical treatment options like radiotherapy and definitive chemoradiation(CRT)have been *** trends in(non-)surgical treatment and its impact on overall survival(OS)in patients with proximal esophageal cancer are unclear,related to its rare disease *** optimize treatment strategies and counseling of patients with proximal esophageal cancer,it is therefore essential to gain more insight through real-life *** To establish trends in treatment and OS in patients with proximal esophageal *** In this population-based study,patients with proximal esophageal cancer diagnosed between 1989 and 2014 were identified in the Netherlands Cancer *** proximal esophagus consists of the cervical esophagus and the upper thoracic section,extending to 24 cm from the *** in radiotherapy,chemotherapy,and surgery,and OS were *** were stratified by presence of distant *** Cox proportional hazards regression analyses was performed to assess the effect of period of diagnosis on OS,adjusted for patient,tumor,and treatment *** In total,2783 patients were *** the study period,the use of radiotherapy,resection,and CRT in non-metastatic disease changed from 53%,23%,and 1%in 1989-1994 to 21%,9%,and 49%in 2010-2014,*** metastatic disease,the use of chemotherapy and radiotherapy increased over *** OS of the total population increased from 7.3 mo[95%confidence interval(CI):6.4-8.1]in 1989-1994 to 9.5 mo(95%CI:8.1-10.8)in 2010-2014(logrank P<0.001).In non-metastatic disease,5-year OS rates improved from 5%(95%CI:3%-7%)in 1989-1994 to 13%(95%CI:9%-17%)in 2010-2014(logrank P<0.001).Multivariable regression analysis demonstrated a significant treatment effect over time on ***

关键词： Esophagus Esophageal cancer Proximal Cervical Upper thoracic Trends Treatment Survival Outcome

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