Kauppila JH, Mattsson F, Brusselaers N, et al Prognosis of oesophageal adenocarcinoma and squamous cell carcinoma following surgery and no surgery in a nationwide Swedish cohort study BMJ Open 2018;8:e021495. doi: 10.1136/bmjopen-2018-021495
Prognosis of oesophageal adenocarcinoma and squamous cell carcinoma following surgery and no surgery in a nationwide Swedish cohort study
|Author:||Kauppila, Joonas H1,2; Mattsson, Fredrik1; Brusselaers, Nele3;|
1Department of Molecular Medicine and Surgery, Upper Gastrointestinal Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
2Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
3Department of Microbiology, Tumor and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Stockholm, Sweden
4School of Cancer Sciences, King’s College London and Guy’s and St Thomas’ NHS Foundation Trust, London, UK
|Online Access:||PDF Full Text (PDF, 0.6 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2018090634737
|Publish Date:|| 2018-09-06
Objectives: To assess the recent prognostic trends in oesophageal adenocarcinoma and oesophageal squamous cell carcinoma undergoing resectional surgery and no such surgery. Additionally, risk factors for death were assessed in each of these patient groups.
Design: Cohort study.
Setting: A population-based, nationwide study in Sweden.
Participants: All patients diagnosed with oesophageal adenocarcinoma and oesophageal squamous cell carcinoma in Sweden from 1 January 1990 to 31 December 2013, with follow-up until 14 May 2017.
Outcome measures: Observed and relative (to the background population) 1-year, 3-year and 5-year survivals were analysed using life table method. Multivariable Cox regression provided HR with 95% CI for risk factors of death.
Results: Among 3794 patients with oesophageal adenocarcinoma and 4631 with oesophageal squamous cell carcinoma, 82% and 63% were men, respectively. From 1990–1994 to 2010–2013, the relative 5-year survival increased from 12% to 15% for oesophageal adenocarcinoma and from 9% to 12% for oesophageal squamous cell carcinoma. The corresponding survival following surgery increased from 27% to 45% in oesophageal adenocarcinoma and from 24% to 43% in oesophageal squamous cell carcinoma. In patients not undergoing surgery, the survival increased from 3% to 4% for oesophageal adenocarcinoma and from 3% to 6% for oesophageal squamous cell carcinoma. Women with oesophageal squamous cell carcinoma had better prognosis than men both following surgery (HR 0.71, 95% CI 0.61 to 0.83) and no surgery (HR 0.86, 95% CI 0.81 to 0.93).
Conclusions: The prognosis has improved over calendar time both in oesophageal adenocarcinoma and oesophageal squamous cell carcinoma in Sweden that did and did not undergo surgery. Women appear to have better prognosis in oesophageal squamous cell carcinoma than men, independent of treatment.
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
This work was supported by the Swedish Research Council (Vetenskapsrådet) (JL), the Swedish Cancer Society (Cancerfonden) (JL), Sigrid Jusélius Foundation (Sigrid Juséliuksen Säätiö) (JHK) and Orion Research Foundation (Orionin Tutkimussäätiö) (JHK).
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