title: Gender differences in prognosis after esophagectomy for esophageal cancer.
abstract: OBJECTIVE
  The purpose of this study was to clarify the gender differences in the prognosis, as well as mortality and morbidity, of patients who have undergone esophagectomy for esophageal cancer.
  
  
  METHODS
  The clinical results of esophagectomy were compared between 975 male and 156 female patients with esophageal cancer.
  
  
  RESULTS
  The male to female ratios of cervical and thoracic esophageal cancer were 1.87 and 7.38, respectively (P < 0.01). The incidence of preoperative comorbidities was 32.4 and 17.4 %, respectively, and the rates of both tobacco and alcohol abuse were significantly lower in the females than in the males. The mortality rate was lower in the females (3.8 %) than in the males (5.7 %), although the differences were not significant. The overall survival was significantly better in the female than in the male patients (P = 0.039). The 5- and 10-year overall survival rates were 32.6 and 20.5 % in the males and 39.5 and 32.5 % in the females, respectively. A multivariate analysis revealed gender to be an independent prognostic factor. However, no significant differences were recognized in disease-specific survival.
  
  
  CONCLUSIONS
  These results suggest that the prognosis of females with esophageal cancer is better than that of males after esophagectomy, most likely due to multiple clinical factors, such as a more favorable lifestyle and general status.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan, masarum@surg2.med.kyushu-u.ac.jp.
authors.forename: Masaru
authors.initials: M
authors.lastname: Morita
authors.forename: Hajime
authors.initials: H
authors.lastname: Otsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawano
authors.forename: Yuta
authors.initials: Y
authors.lastname: Kasagi
authors.forename: Yasue
authors.initials: Y
authors.lastname: Kimura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saeki
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ida
authors.forename: Eiji
authors.initials: E
authors.lastname: Oki
authors.forename: Eriko
authors.initials: E
authors.lastname: Tokunaga
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ikeda
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kusumoto
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015897:Comorbidity; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors
references.citation: Surg Today. 2011 Sep;41(9):1190-5
references.pmid: 21874413
references.citation: J Natl Cancer Inst. 2003 Sep 17;95(18):1404-13
references.pmid: 13130116
references.citation: J Trauma. 2000 May;48(5):832-9; discussion 839-40
references.pmid: 10823526
references.citation: Br J Surg. 1980 Jul;67(7):457-61
references.pmid: 6158354
references.citation: J Gastrointest Surg. 2008 Mar;12(3):518-26
references.pmid: 17823842
references.citation: Ann Thorac Cardiovasc Surg. 2001 Dec;7(6):325-9
references.pmid: 11888470
references.citation: World J Surg. 2007 Oct;31(10):1982-7
references.pmid: 17676426
references.citation: J Surg Res. 2009 Dec;157(2):227-34
references.pmid: 19394964
references.citation: Int J Cancer. 1998 May 18;76(4):468-71
references.pmid: 9590119
references.citation: Int J Cancer. 1994 Jul 15;58(2):207-10
references.pmid: 8026883
references.citation: J Clin Oncol. 2012 Jun 20;30(18):2265-72
references.pmid: 22585694
references.citation: Surgery. 2008 Apr;143(4):499-508
references.pmid: 18374047
references.citation: Surg Gynecol Obstet. 1987 Jun;164(6):541-4
references.pmid: 3589909
references.citation: J Epidemiol. 2008;18(6):251-64
references.pmid: 19075498
references.citation: Cytokine. 1996 Nov;8(11):853-63
references.pmid: 9047082
references.citation: Shock. 2000 Aug;14(2):81-90
references.pmid: 10947147
references.citation: Ann Surg. 2003 Sep;238(3):339-47; discussion 347-8
references.pmid: 14501500
references.citation: Eur J Cancer. 2009 Dec;45(18):3149-55
references.pmid: 19804965
references.citation: Surg Today. 2012 Aug;42(8):752-8
references.pmid: 22370963
references.citation: Cancer Res. 1990 Nov 15;50(22):7212-5
references.pmid: 2224855
references.citation: Ann Surg. 1980 Jul;192(1):44-52
references.pmid: 7406563
references.citation: Ann Thorac Surg. 2004 Oct;78(4):1177-83
references.pmid: 15464466
references.citation: Ann Surg Oncol. 2011 Jun;18(6):1757-65
references.pmid: 21207167
references.citation: Br J Surg. 1990 Aug;77(8):845-57
references.pmid: 2203505
references.citation: Ann Surg. 2000 Aug;232(2):225-32
references.pmid: 10903602
references.citation: Am J Otolaryngol. 2007 Jan-Feb;28(1):22-4
references.pmid: 17162126
references.citation: Cancer. 1994 Nov 1;74(9):2425-9
references.pmid: 7922995