Determinants of survival outcomes among esophageal cancer patients at a national referral hospital in Kenya. Issue 1 (20th November 2022)

• Record Type: Journal Article
• Authors: Degu, Amsalu; Karimi, Peter N.; Opanga, Sylvia A.; Nyamu, David G.
• Other Names: Cui Yi handlingEditor.
• Is Part Of: Chronic diseases and translational medicine. Volume 9:Issue 1(2023)
• Page Start: 20
• Page End: 28
• Publication Date: 2022-11-20
• Subjects: determinants -- esophageal cancer -- mortality -- survival outcomes; Chronic diseases -- Periodicals; Medicine -- Research -- Periodicals; Chronic diseases; Medicine -- Research; Chronic Disease; Translational Medical Research; Periodicals; Electronic journals; Fulltext; Internet Resources; Periodicals; Periodical; 616.044
• DOI: 10.1002/cdt3.52
• Languages: English
• ISSNs: 2095-882X

Abstract

Abstract: Introduction: The overall 5‐year survival rate for esophageal cancer patients in low‐ and middle‐income countries was reported to be low, despite the availability of advanced treatments. Thus, this study aimed to assess determinants of survival outcomes among esophageal cancer patients in Kenya. Methods: A retrospective cohort study was employed among 299 adult esophageal cancer patients. The data were collected using a data abstraction tool consisting of patients' clinical characteristics and survival outcome measuring parameters. Statistical Package for the Social Sciences (SPSS) statistical software (version 20.0, IBM. USA) was used to analyze the data. The Kaplan–Meier and Cox regression analyses were used to determine the survival outcome and determinants of mortality, respectively. Results: The mortality rate was 43.1%, and 11.1% of patients demonstrated distant metastases in the follow‐up period. Despite treatment, 20.1% had progressed disease, and 13.0% did not respond to treatment. Radiotherapy (AHR: 3.3, 95% CI: 1.4−7.8, p = 0.007), chemotherapy (AHR: 3.9, 95% CI: 1.2−6.1, p = 0.020), and chemoradiation (AHR: 5.6, 95%CI: 1.6−10.2, p = 0.006) were the significant determinants of survival in advanced stage (III and and IV) patients. Conclusions: There was a high mortality rate, disease progression, and nonresponse of esophageal cancer patients. Hence, it is essential to improve the survival of patients through early detection and timely initiation of the available treatment options. Key points: There was a high mortality rate, disease progression, and nonresponse of esophageal cancer patients. Radiotherapy, chemotherapy, and chemoradiation were the significant determinants of survival in the advanced stage (III and and IV). Esophagectomy was the only treatment modality with a statistically significant effect on the survival outcomes of early‐stage patients (I and II). Therefore, this study gave direction about the essence of early detection and timely initiation of the available treatment options to improve survival.