Prognostic factors for medium- and long-term survival of esophageal cancer patients in the Netherlands.
OBJECTIVE
Medium- and long-term survival is low in esophageal cancer (EC) patients, which is thought to be due to tumor characteristics. Our aim was to determine both tumor- and non-tumor-related characteristics affecting survival in these patients.


METHODS
Patients with primary EC between 1990 and 2008 in the southern part of the Netherlands were identified. Multivariable logistic regression was used to identify determinants of survival.


RESULTS
In total, 703 patients with EC were included for the 1-year, 551 for the 3-year and 436 for the 5-year survival analysis. Poor 1-year survival was independently associated with chemoradiation (compared to surgery), positive lymph nodes (N1-stage) and 1 or ≥2 comorbidities. Adenocarcinoma (EAC) compared to squamous cell carcinoma was significantly associated with a better 1-year survival. Poor 3- and 5-year survival was associated with N1-stage and chemoradiation. Positive prognostic factors for 3- and 5-year survival were neoadjuvant therapy and female gender.


CONCLUSIONS
Both tumor-related (negative lymph nodes and EAC histology) and non-tumor-related factors (surgery, neoadjuvant therapy, and female gender) are associated with a better survival of EC. Although it is not clear how histology and gender affect EC survival, knowledge of these factors may be relevant for clinical decision making.
Pauline
P
Bus
Valery E
VE
Lemmens
Martijn G
MG
van Oijen
Geert-Jan
GJ
Creemers
Grard A
GA
Nieuwenhuijzen
Jantine W
JW
van Baal
Peter D
PD
Siersema
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D002454:Cell Differentiation; D015986:Confounding Factors, Epidemiologic; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors