Influence of socio-economic deprivation on outcomes for patients diagnosed with oesophageal cancer.
OBJECTIVE
To determine the influence of deprivation on outcomes for patients with oesophageal cancer.


METHODS
A total of 1196 consecutive patients with oesophageal carcinoma presenting to a regional multidisciplinary team between 1 January 1998 and 31 August 2005 were studied prospectively and deprivation scores calculated using the Indices of Multiple Deprivation (IMD) of the National Assembly for Wales. The patients were subdivided into quintiles for analysis.


RESULTS
Inhabitants of the most deprived areas (quintile 5) were younger at presentation (median age 67 years versus 70 years, p = 0.01) and were more likely to have squamous cell carcinomas (SCCs) (p = 0.002) in comparison with patients from the least deprived areas (quintile 1). Stage of disease and morbidity did not correlate with deprivation quintile, but operative mortality was greater in quintile 1 versus 5 (1.9% versus 5.8%, p = 0.281). Overall 5-year survival for those patients undergoing oesophagectomy was unrelated to deprivation quintile (1 versus 5, 24% versus 33%, p = 0.8246), but was lower following definitive chemoradiotherapy (dCRT) for the least deprived quintiles (1, 2 & 3 versus 4 & 5, 35% versus 16%, p = 0.0272).


CONCLUSIONS
Although deprivation was associated with younger age, SCC and a trend towards higher operative mortality, survival after diagnosis and oesophagectomy were unrelated to deprivation.
Morgan
Matthew A
MA
South East Wales Cancer Network, University Hospital of Wales, Cardiff, UK.
Lewis
Wyn G
WG
Chan
David S Y
DS
Burrows
Sarah
S
Stephens
Michael R
MR
Roberts
S Ashley
SA
Havard
Timothy J
TJ
Clark
Geoffrey W B
GW
Crosby
Tom D L
TD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000191:economics* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010348:Patient Care Team; D012959:Socioeconomic Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014852:Wales