No abstract

No abstract

Background Outcomes data comparing endoscopic eradication therapies (EET) and esophagectomy are limited in patients with early esophageal cancer (EC). Objective To compare overall survival and EC-related mortality in patients with early EC treated with EET and esophagectomy. Design and setting Population-based study Patients Patients with early EC (stage T0 and T1) were identified from the SEER database (1998–2009). Demographics, tumor specific data and survival were compared. Cox proportional hazards regression models were used to evaluate association between treatments and EC-specific mortality. Intervention EET and esophagectomy Main outcome measurements (i) Mid (2-years) and long-term (5-years) overall survival and esophageal cancer specific mortality, (ii) Outcomes based on histology and stage and (iii) treatment patterns and predictors of cancer-specific mortality. Results 430 (21%) and 1,586 (79%) underwent EET and esophagectomy, respectively. There was no difference in the 2-year (EET: 10.5% vs. esophagectomy: 12.7%, p=0.27).and 5-year (EET: 36.7% vs. esophagectomy: 42.8%, p=0.16) EC related mortality rates between the two groups. EET patients had higher mortality rates due to non-EC causes (5-years: 46.6% vs. 20.6%, p<0.001). Similar results were noted when comparisons were limited to patients with T0 and T1a disease and EAC. There was no difference in EC-specific mortality in the EET compared to surgery group [HR: 1.4 (95% CI 0.9–2.03)]. Variables associated with mortality were older age, year of diagnosis, radiation therapy, higher stage and ESCC. Limitations Comorbidities, recurrence rates not available. Conclusions This population-based study demonstrates comparable mid and long-term EC- related mortality in patients with early EC undergoing EET and surgical resection.

No abstract