[Survival prognostic factors in a cohort of patients with esophageal carcinoma].
BACKGROUND
The epidemiology of esophageal carcinoma (EC) has changed in the last decades. Adenocarcinoma and squamous cell carcinoma are analyzed as a single condition because prognosis is similar. The aim of this study was to define prognostic factors in EC, considering each histopathologic type independently.


METHODS
We studied a retrospective cohort of patients treated from 1981 to 2001 at the National Cancer Institute (Instituto Nacional de Cancerología, INCan) in Mexico City. Patients with EC (including siewert I type neoplasms), with endoscopic biopsy, of adenocarcinoma or squamous cell carcinoma older than 18 years of age, and with complete clinical evaluation were included in the study.


RESULTS
A total of 236 cases were included: 60 (25.4%) were adenocarcinoma and 176 (74.6%), squamous cell carcinoma. Median survival times were 5.2 months (95% CI, 0.7 to 9.6) and 2.9 months (95% CI, 2.2 to 3.6 months), respectively (p = 0.0042). In bivariate analysis, age, histopathologic type, T classification, M classification, differentiation grade, history of hiatal hernia, presence of Barrett esophagus, anemia, surgical resection, and use of other antineoplastic treatments were related to survival (p = 0.00001).


CONCLUSIONS
At our hospital, EC is a lethal neoplasia with a dismal prognosis. Adenocarcinoma has a better prognosis than squamous cell carcinoma. However, in multivariate analysis, T classification and possibility of surgical resection were the most important prognostic factors determining survival.
Navarrete Alemán
Jaime
J
Subdirección de Cirugía, Instituto Nacional de Cancerología, México, DF.
Oñate Ocaña
Luis F
LF
Herrera Goepfert
Roberto
R
Moreno Varaona
Jesús Zamora
JZ
Mondragón Sánchez
Ricardo
R
Aiello Crocifoglio
Vincenzo
V
D000230:Adenocarcinoma / Q000401:mortality* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000628:therapy; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis