title: Symptoms, investigations and management of patients with cancer of the oesophagus and gastro-oesophageal junction in Australia.
abstract: OBJECTIVE
  To document presenting symptoms, investigations and management for Australian patients with oesophageal adenocarcinoma (OAC), gastro-oesophageal junction adenocarcinoma (GOJAC) and oesophageal squamous cell carcinoma (OSCC).
  
  
  METHODS
  Cross-sectional study of a population-based sample of 1100 Australian patients aged 18-79 years with histologically confirmed oesophageal cancer diagnosed in 2002-2005, using data from cancer registries and treatment centres, supplemented with clinical information collected through medical record review in 2006-2007 and mortality information collected in 2008.
  
  
  METHODS
  Prevalence of primary symptoms, and staging investigations and treatment modalities used.
  
  
  RESULTS
  The primary presenting symptom was dysphagia, which was self-reported by 41%, 39% and 48% of patients with OAC, GOJAC and OSCC, respectively. Less common symptoms were reflux, chest pain, bleeding and weight loss. All patients underwent endoscopy, most had a staging computed tomography scan (OAC 93%, GOJAC 95% and OSCC 93%), and about half had positron emission tomography scans (OAC 51%, GOJAC 44% and OSCC 42%). Pretreatment tumour stage was reported in 25% of records, and could be derived from results of investigations in a further 23%, but the remaining half lacked sufficient information to ascribe a pretreatment stage. Curative treatments were attempted for 60% of OAC, 88% of GOJAC and 65% of OSCC patients. Surgery was performed on 52% of OAC, 83% of GOJAC and 41% of OSCC patients. About two-thirds of surgical patients received additional therapies.
  
  
  CONCLUSIONS
  With anticipated increases in oesophageal cancer incidence, the resources required to diagnose and manage patients with oesphageal cancer are also likely to rise. Our data provide a baseline from which to plan for the future care of patients with cancers of the oesophagus.
authors.affiliation: Upper GI and Soft Tissue Unit, Division of Surgery, Princess Alexandra Hospital, Brisbane, QLD, Australia.
authors.forename: Bernard M
authors.initials: BM
authors.lastname: Smithers
authors.forename: Paul P
authors.initials: PP
authors.lastname: Fahey
authors.forename: Tracie
authors.initials: T
authors.lastname: Corish
authors.forename: David C
authors.initials: DC
authors.lastname: Gotley
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Falk
authors.forename: Garett S
authors.initials: GS
authors.lastname: Smith
authors.forename: George K
authors.initials: GK
authors.lastname: Kiroff
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Clouston
authors.forename: David I
authors.initials: DI
authors.lastname: Watson
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology*; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D004943:Esophagogastric Junction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D017678:Sex Distribution