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Sex differences in the prognosis after surgery for esophageal squamous cell carcinoma and adenocarcinoma.
- Source :
-
International journal of cancer [Int J Cancer] 2019 Mar 15; Vol. 144 (6), pp. 1284-1291. Date of Electronic Publication: 2018 Oct 31. - Publication Year :
- 2019
-
Abstract
- Some investigations suggest a better prognosis in women compared to men with esophageal cancer but these differences are uncertain. The aim of our study was to clarify whether sex influences the prognosis after esophagectomy for esophageal squamous cell carcinoma and esophageal adenocarcinoma. A population-based and nationwide cohort study included almost all patients who underwent esophagectomy for esophageal cancer in Sweden in 1987-2010, with follow-up until 2016. Patients' sex was analyzed in relation to risk of mortality. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period, age, education, comorbidity, tumor stage, neoadjuvant therapy, and surgeon volume. Among 1,816 participants, 1,024 (56%) had esophageal squamous cell carcinoma (355 [35%] women), and 792 (44%) had esophageal adenocarcinoma (103 [13%] women). Compared to men, women had a decreased overall all-cause mortality in esophageal squamous cell carcinoma (HR = 0.73, 95% CI 0.63-0.85). Stratified analyses showed decreased mortality limited to women aged >55 years (HR = 0.71, 95% CI 0.61-0.83), but in all tumor stages, particularly stages 0-I (HR = 0.54, 95% CI 0.37-0.79). Women also had decreased 90-day all-cause mortality, 5-year all-cause mortality, and 5-year disease-specific mortality in esophageal squamous cell carcinoma compared to men. For esophageal adenocarcinoma, no sex differences were found for any of the mortality outcomes. Thus, women who undergo esophagectomy for esophageal squamous cell carcinoma seem to have better prognosis than men, especially those with early tumor stages, whereas no sex differences in prognosis were found for esophageal adenocarcinoma.<br /> (© 2018 UICC.)
- Subjects :
- Adenocarcinoma pathology
Adenocarcinoma therapy
Aged
Esophageal Neoplasms pathology
Esophageal Neoplasms therapy
Esophageal Squamous Cell Carcinoma pathology
Esophageal Squamous Cell Carcinoma therapy
Esophagus pathology
Esophagus surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoadjuvant Therapy methods
Neoplasm Staging
Prognosis
Risk Factors
Sex Factors
Survival Analysis
Sweden epidemiology
Treatment Outcome
Adenocarcinoma mortality
Esophageal Neoplasms mortality
Esophageal Squamous Cell Carcinoma mortality
Esophagectomy
Registries statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1097-0215
- Volume :
- 144
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- International journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 30168595
- Full Text :
- https://doi.org/10.1002/ijc.31840