title: Temporal trends in long-term survival and cure rates in esophageal cancer: a SEER database analysis.
abstract: OBJECTIVE
  To assess long-term temporal trends in population-based survival and cure rates in patients with esophageal cancer and compare them over the last 3 decades in the United States.
  
  
  METHODS
  We identified 62,523 patients with cancer of the esophagus and the gastric cardia diagnosed between 1973 and 2007 from the Surveillance, Epidemiology, and End Results database. Long-term cancer-related survival and cure rates were calculated. Stage-by-stage disease-related survival curves of patients diagnosed in different decades were compared. Influence of available variables on survival and cure was analyzed with logistic regression.
  
  
  RESULTS
  Ten-year survival was 14% in all patients. Disease-related survival of esophageal cancer improved significantly since 1973. Median survival in Surveillance, Epidemiology, and End Results stages in local, regional, and metastatic cancers improved from 11, 10, and 4 months in the 1970s to 35, 15, and 6 months after 2000. Early stage, age 45 to 65 years at diagnosis and undergoing surgical therapy were independent predictors of 10-year survival. Cure rate improved in all stages during the study period and were 73%, 37%, 12%, and 2% in stages 0, 1, 2, and 4, respectively, after the year 2000. Percentage of patients undergoing surgery improved from 55% in the 1970s to 64% between 2000 and 2007. Proportion of patients diagnosed with in situ and local cancer remains below 30%.
  
  
  CONCLUSIONS
  Long-term survival with esophageal cancer is poor but survival of local esophageal cancer improved dramatically over the decades. Complete cure of nonmetastatic esophageal cancer seems possible in a growing number of patients. Early diagnosis and treatment are crucial.
authors.affiliation: Department of Surgery, Klinikum Nürnberg, Nuremberg, Germany. dubeczattila@gmail.com
authors.forename: Attila
authors.initials: A
authors.lastname: Dubecz
authors.forename: Isabell
authors.initials: I
authors.lastname: Gall
authors.forename: Norbert
authors.initials: N
authors.lastname: Solymosi
authors.forename: Michael
authors.initials: M
authors.lastname: Schweigert
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Peters
authors.forename: Marcus
authors.initials: M
authors.lastname: Feith
authors.forename: Hubert J
authors.initials: HJ
authors.lastname: Stein
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate; D013997:Time Factors; D014481:United States