Patterns of care and outcomes in oesophageal cancer. Issue 11 (November 2018)

• Record Type: Journal Article
• Authors: Jooste, Valerie; Manfredi, Sylvain; Napoleon, Marie; Drouillard, Antoine; Marref, Imene; Bedenne, Laurent; Faivre, Jean; Bouvier, Anne-Marie
• Is Part Of: Digestive and liver disease. Volume 50:Issue 11(2018)
• Page Start: 1238
• Page End: 1243
• Publication Date: 2018-11
• Subjects: Chemoradiation -- Oesophageal cancer -- Outcomes -- Population-based cancer registry -- Surgery; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2018.07.011
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: The optimal treatment for oesophageal cancer is a matter of debate. The aim of this study was to describe patterns of care and survival in a well-defined population for squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the oesophagus. Design: Data were provided by the Digestive Cancer Registry of Burgundy (France). Recurrence, excess mortality and net survival were calculated. Results: Among non-metastatic patients, the proportion of patients resected for cure decreased between 2004 and 2013 from 16% to 9% for SCC and 48% to 22% for AC. The administration of chemoradiation increased from 45 to 53% for SCC and 21 to 30% for AC. A complete clinical response to chemoradiation was reported in 40% of the patients. Five-year net survival did not vary according to histology. It was 55% in the selected group of patients resected for cure, 44% in patients treated with chemoradiation with a complete clinical response. In multivariate analysis, treatment modality only was associated with survival. In metastatic patients, 3-year net survival was 14% for those treated with chemoradiation. Conclusion: Chemoradiation has become the most frequently administered treatment. Cancelling or postponing surgery after chemoradiation with complete response should be assessed by a randomized clinical trial.