Survival of Esophageal Cancer in China: A Pooled Analysis on Hospital-Based Studies From 2000 to 2018

Abstract

Background: Esophageal cancer (EC) causes more than 400 thousand deaths per year, and half of them occur in China. There are discrepancies regarding the survival of EC patients between population-based surveillance studies and hospital-based studies. Objectives: We aimed to synthesize the survival data from hospital-based EC studies in the Chinese population from 2000 to 2018 and to compare the survival rates between EC patients with different clinical classifications. Methods: The protocol of this systematic review was registered in PROSPERO (CRD-42019121559). We searched Embase, PubMed, CNKI, and Wanfang databases for studies published between January 1, 2000 and December 31, 2018. We calculated the pooled survival rates and 95% confidence intervals (CIs) by Stata software (V14.0). Results: Our literature search identified 933 studies, of which 331 studies with 79,777 EC patients met the inclusion criteria and were included in meta-analyses. The pooled survival rates were 74.1% (95% CI: 72.6–75.7%) for 1-year survival, 49.0% (95% CI: 44.2–53.8%) for 2-years survival, 46.0% (95% CI: 42.6–49.5%) for 3-years survival, and 40.1% (95% CI: 33.7–46.4%) for 5-years survival. An increased tendency toward EC survival was verified from 2000 to 2018. In addition, discrepancies were observed between EC patients with different clinical classifications (e.g., stages, histologic types, and cancer sites). Conclusions: Our findings showed a higher survival rate in hospital-based studies than population-based surveillance studies. Although this hospital-based study is subject to potential representability and publication bias, it offers insight into the prognosis of patients with EC in China.

Understanding Esophageal Cancer: The Challenges and Opportunities for the Next Decade

“…ESCC is the predominant histological subtype of EC in China, accounting for 88.84% of all EC cases in the Chinese population (17). Although increasing survival of EC patients were observed in both population-based and hospital-based studies (18,19), the prognosis for ESCC/EC in China is relatively poor when compared to other cancers, as most studies reported that EC patients had a 5-year survival rate between 15 and 25% (20,21). In a population-based study including 1,033 ESCC patients who received surgery, patients in stages IA, IB, IIA, IIB, IIIA, IIIB, IIIC, and IV had a 5-year survival rate of 84.9, 70.9, 56.2, 43.3, 37.9, 23.3, 12.9, and 3.4%, respectively (22).…”

“…Importantly, the survival for those ESCC patients with distant organ metastasis at the first diagnosis is particularly poor, as a retrospective study indicated that these patients had a median survival of only 6 months with 1-or 2-year survival rates of 21.1 or 11.8% (24), respectively. Furthermore, hospital-based studies also suggested that the 5-year survival rate of EC patients was <20% (19,25).…”

SREBP1 silencing inhibits the proliferation and motility of human esophageal squamous carcinoma cells via the Wnt/β‑catenin signaling pathway

“…Of all reported esophageal cancer subtypes, ~90% are esophageal squamous cell carcinoma (ESCC) globally each year, which is usually present at an advanced stage and is mostly concentrated in China ( 2 , 3 ). As many as 90% of patients with ESCC died from distant invasion and metastasis and 36.8% of patients had lymph node metastasis between January 2010 and July 2016 in China ( 4 , 5 ). Therefore, the molecular mechanisms underlying tumor invasion and metastasis must be investigated to develop novel antineoplastic strategies for metastatic ESCC treatment.…”

Stromal microenvironment promoted infiltration in esophageal adenocarcinoma and squamous cell carcinoma: a multi-cohort gene-based analysis

“…Moreover, advanced tumor is comparatively tolerant to neoadjuvant chemotherapy and radiotherapy due to accumulating drug and ray resistance. The 5-years survival of advanced ESCA patients is merely 15–20% 3 .…”