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Patterns of care and outcomes in oesophageal cancer
Valerie Jooste1, Sylvain Manfredi1, Marie Napoleon1
1Digestive Cancer Registry of Burgundy, INSERM, LNC UMR1231, University 'Bourgogne Franche-Comté', Dijon-Bourgogne University Hospital, Dijon, France.
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.
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