Trends in incidence and management of esophageal adenocarcinoma in a well-defined population.
OBJECTIVE
Little epidemiological data is available concerning esophageal adenocarcinomas in France. The aim of this study was to study epidemiological characteristics and management of esophageal adenocarcinoma in a well-defined population.


METHODS
Data were collected by the Burgundy Digestive Cancer Registry covering a population of 1 052 000, over a 28-year period (1976-2001). Incidence, treatment and stage at diagnosis were noted. Univariate and multivariate analysis of survival was performed.


RESULTS
Age standardized incidence rates were 1.60/100,000 in men and 0.15/100,000 in women. The mean increase in incidence rates by 5-year periods were respectively + 68.1% (P<0.001) and + 97.4% (P<0.001). Overall, 69.9% of the cancers were located in the lower third of the esophagus. Surgical resection was performed in 32.1% of patients. Among the surgical patients, the tumor was limited to the esophageal wall in 11.4%, lymph node metastases were present in 18.1% and non-resectable distant metastases in 70.5%. There was no improvement of stage at diagnosis over time. Survival rates were 14.4% at 3 years and 9.2% at 5 years. Five-year survival rates varied from 38.4% for cases limited to the esophageal wall to 1.8% for metastatic and non resectable cases. Stage at diagnosis was the only significant prognostic factor in the multivariate analysis.


CONCLUSIONS
Esophageal adenocarcinomas are rare cancers characterized by a sharp rise in incidence over the past years in France. Stage at diagnosis and prognosis are worse than reported in hospital statistics.
Lepage
Côme
C
Registre Bourguignon des Cancers Digestifs, INSERM EPI 0106.
Bouvier
Anne-Marie
AM
Manfredi
Sylvain
S
Coatmeur
Olivier
O
Cheynel
Nicolas
N
Faivre
Jean
J
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000628:therapy; D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012042:Registries; D015996:Survival Rate