The role of diabetes and other co-morbidities on survival after esophageal cancer surgery in a population-based study

Backemar, Lovisa; Djärv, Therese; Wikman, Anna; Johar, Asif; Ross, Paul; Lagergren, Pernilla; Lagergren, Jesper

doi:10.1016/j.amjsurg.2013.01.035

Cited by 18 publications

(21 citation statements)

References 20 publications

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“…The present study showed no reduced impact on prognosis related to diabetes, confirming the findings of a previous Swedish study 16 . Diabetes has been reported, however, to increase the risk of death in patients with cancer in general 31 , and a single-centre study 32 from the USA, which included 510 patients with oesophageal or cardia cancer, found a 30 per cent increased overall mortality among diabetic patients.…”

Section: Discussionsupporting

confidence: 93%

“…The present study indicated an increased risk of overall mortality in patients with a Charlson score of 2 or more, in line with some other investigations, including a Swedish study based on an earlier version of this cohort. Another Swedish study, which used another database of 609 patients who underwent surgery for oesophageal or cardia cancer in 2001–2005, did not show increased mortality in patients with co‐morbidities in general or in patients with cardiovascular disease, hypertension or pulmonary disease. That study collected information about co‐morbidities from medical charts, whereas the present analysis used ICD codes in the National Patient Registry.…”

Section: Discussionmentioning

confidence: 98%

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Impact of co-morbidity on mortality after oesophageal cancer surgery

Backemar

Lagergren

Johar

et al. 2015

British Journal of Surgery

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Impact of co-morbidity on mortality after oesophageal cancer surgery

Backemar

Lagergren

Johar

et al. 2015

British Journal of Surgery

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“…The histological type was subdivided into adenocarcinoma and squamous cell carcinoma. Numbers of major complications (within 30 days of surgery) and comorbidities were categorised as none, one or more than one, as described previously 11 17. The surgeon volume was categorised into two equally sized groups based on the median annual number of oesophagectomies per surgeon (<8 or ≥8) 15.…”

Section: Methodsmentioning

confidence: 99%

Marital status and survival after oesophageal cancer surgery: a population-based nationwide cohort study in Sweden

et al. 2014

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ObjectivesA beneficial effect of being married on survival has been shown for several cancer types, but is unclear for oesophageal cancer. The objective of this study was to clarify the potential influence of the marital status on the overall and disease-specific survival after curatively intended treatment of oesophageal cancer using a nationwide population-based design, taking into account the known major prognostic variables.DesignProspective, population-based cohort.SettingAll Swedish hospitals performing surgery for oesophageal cancer during 2001–2005.ParticipantsThis study included 90% of all patients with oesophageal or junctional cancer who underwent surgical resection in Sweden in 2001–2005, with follow-up until death or the end of the study period (2012).Primary and secondary outcome measuresCox regression was used to estimate associations between the marital status and the 5-year overall and disease-specific mortality, expressed as HRs with 95% CIs, with adjustment for sex, age, tumour stage, histological type, complications, comorbidities and annual surgeon volume.ResultsOf all 606 included patients (80.4% men), 55.1% were married, 9.2% were remarried, 22.6% were previously married and 13% were never married. Compared with the married patients, the never married (HR 1.02, 95% CI 0.77 to 1.35), previously married (HR 0.90, 95% CI 0.71 to 1.15) and remarried patients (HR 0.79, 95% CI 0.55 to 1.13) had no increased overall 5-year mortality. The corresponding HRs for disease-specific survival, and after excluding the initial 90 days of surgery, were similar to the HRs for the overall survival.ConclusionsThis study showed no evidence of a better 5-year survival in married patients compared with non-married patients undergoing surgery for oesophageal cancer.

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“…A previous study involving a large cohort and meta‐analysis provided evidence that a higher BMI was associated with favorable survival in patients with ESCC . However, other studies found that diabetes did not strongly increase the risk of mortality in patients with esophageal cancer . Additionally, several studies have evaluated serum lipid levels .…”

Section: Discussionmentioning

confidence: 99%

“…Despite advances in the management of patients with esophageal cancer, the prognosis and survival remain universally poor, and the overall 5‐year survival rates are 5–15% . There is a evidence suggesting that metabolic factors such as body mass index (BMI), diet or obesity, diabetes, and serum lipid levels affect the survival of esophageal cancer patients …”

Section: Introductionmentioning

confidence: 99%

Impact of metabolic syndrome on the survival of Chinese patients with resectable esophageal squamous cell carcinoma

et al. 2015

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Metabolic syndrome (MetS) is associated with the risk of esophageal squamous cell carcinoma (ESCC). However, the impact of MetS on survival has not been evaluated. A retrospective review was performed on 596 consecutive Chinese patients with esophageal squamous cell carcinoma who received surgery between January 2005 and October 2007. The clinical data and pretreatment information related to MetS were reviewed. The impact of MetS on overall survival (OS) was estimated by Kaplan-Meier and Cox proportional hazards analyses. MetS was a significant and independent predictor for better survival in patients with resectable ESCC. The 3-year OS and 5-year OS for patients with and without MetS were 75.0% versus 57.8% and 65.1% versus 44.6%, respectively (P = 0.005 in the univariate analysis, P = 0.010 in multivariate analysis). However, there was no apparent influence of any single component of MetS on OS. The other independent prognostic factors identified in the univariate analysis included the following: gender, smoking status, alcohol use, the extent of radical surgical resection, T and N stage, and tumor differentiation. The results of the multivariate analysis included the extent of radical surgery resection, T and N stage, and tumor differentiation. MetS was also associated with greater tumor cell differentiation (P = 0.036). There was no association found between MetS status and postoperative complications. MetS is an independent prognostic factor for OS in patients with ESCC and is associated with better tumor cell differentiation.

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The role of diabetes and other co-morbidities on survival after esophageal cancer surgery in a population-based study

Cited by 18 publications

References 20 publications

Impact of co-morbidity on mortality after oesophageal cancer surgery

Impact of co-morbidity on mortality after oesophageal cancer surgery

Marital status and survival after oesophageal cancer surgery: a population-based nationwide cohort study in Sweden

Impact of metabolic syndrome on the survival of Chinese patients with resectable esophageal squamous cell carcinoma

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