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Prognostic factors for medium‐ and long‐term survival of esophageal cancer patients in the Netherlands
Author(s) -
Bus Pauline,
Lemmens Valery E.,
van Oijen Martijn G.,
Creemers GeertJan,
Nieuwenhuijzen Grard A.,
van Baal Jantine W.,
Siersema Peter D.
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23513
Subject(s) - medicine , esophageal cancer , stage (stratigraphy) , oncology , adenocarcinoma , survival analysis , histology , cancer , logistic regression , carcinoma , esophagectomy , neoadjuvant therapy , proportional hazards model , survival rate , breast cancer , paleontology , biology
Background and Objectives Medium‐ and long‐term survival is low in esophageal cancer (EC) patients, which is thought to be due to tumor characteristics. Our aim was to determine both tumor‐ and non‐tumor‐related characteristics affecting survival in these patients. Methods Patients with primary EC between 1990 and 2008 in the southern part of the Netherlands were identified. Multivariable logistic regression was used to identify determinants of survival. Results In total, 703 patients with EC were included for the 1‐year, 551 for the 3‐year and 436 for the 5‐year survival analysis. Poor 1‐year survival was independently associated with chemoradiation (compared to surgery), positive lymph nodes (N1‐stage) and 1 or ≥2 comorbidities. Adenocarcinoma (EAC) compared to squamous cell carcinoma was significantly associated with a better 1‐year survival. Poor 3‐ and 5‐year survival was associated with N1‐stage and chemoradiation. Positive prognostic factors for 3‐ and 5‐year survival were neoadjuvant therapy and female gender. Conclusion Both tumor‐related (negative lymph nodes and EAC histology) and non‐tumor‐related factors (surgery, neoadjuvant therapy, and female gender) are associated with a better survival of EC. Although it is not clear how histology and gender affect EC survival, knowledge of these factors may be relevant for clinical decision making. J. Surg. Oncol. 2014 109:465–471 . © 2013 Wiley Periodicals, Inc.