Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients

BACKGROUND: Esophageal cancer ranks eighth among the most prevalent cancers globally and is the sixth leading cause of mortality from malignancy worldwide; it is the 7th most prevalent malignancy in males and the 6th most prevalent malignancy in females. In Pakistan, the incidence is 4.1 per 100 000 with the province of Baluchistan having the greatest incidence. OBJECTIVE: Report trends and characteristics of esophageal cancer in Pakistan over the past 10 years. DESIGN: Cross-sectional, retrospective review of medical records. SETTING: Tertiary care hospital. PATIENTS AND METHODS: The study included all patients admitted with a diagnosis of esophageal carcinoma with a mass lesion or luminal narrowing. The records were for the period from January 2011 to September 2020. MAIN OUTCOME MEASURES: Gender, histopathological types/differentiation along with clinical/laboratory findings. SAMPLE SIZE: 1009 with a mean (standard deviation) age of 49.3 (14.2) and a median (interquartile range of 50 (22) years (443 males and 566 females with age of 51.0 [20] years and 47.9 [23.8] years, respectively). The male-to-female ratio was 1:1.2. RESULTS: Most patients (82.7%) had squamous cell carcinomas with a male-to-female ratio of 1:2; the remainder had adenocarcinomas with a male-to-female ratio of 4:1 ( P <.001). Dysphagia, weight loss, and vomiting were the most prevalent symptoms. More adenocarcinoma masses were located distally compared with squamous cell carcinomas ( P =.030), lesions were most likely to be ulcerated ( P =.910). Luminal narrowing was slightly more frequent in squamous cell carcinoma ( P =.215), thickening was more prominently circumferential in the adenocarcinomas. In squamous cell carcinoma, the most common variant was moderately differentiated while moderate to poorly differentiated variants were more common in adenocarcinoma. In the survival analysis, squamous cell carcinoma ( P =.014 vs adenocarcinoma), particularly the well-differentiated type ( P =.018 vs other variants), projected a better prognosis. CONCLUSION: Our study reports the most recent trends of esophageal carcinoma in this region. LIMITATIONS: Lack of metastatic workup, TNM staging, and mode of treatment, along with the overlapping pattern of histological variants. CONFLICT OF INTEREST: None.

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“… 33 A nationwide survey in Korea comprising of 6354 patients also reported decreased survival with a worsening staging of the tumor. 34 …”

Section: Discussionmentioning

confidence: 99%

Clinical, epidemiological, and diagnostic characteristics of esophageal carcinoma in a Pakistani population

et al. 2021

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“…ESCA is one of the most common tumors and a notable threat to human health ( 18 ). Despite traditional therapies having improved greatly, the prognosis and 5-year survival rates of patients with ESCAs remain poor ( 19 ). Due to the lack of obvious early symptoms and precise tumor markers, the vast majority of patients with ESCA are diagnosed at a late stage before treatment ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

MicroRNA‑454‑3p inhibits cell proliferation and invasion in esophageal cancer by targeting insulin‑like growth factor 2 mRNA‑binding protein 1

et al. 2020

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Esophageal cancer (ESCA) is the eighth most common cause of cancer-associated mortality in humans. An increasing number of studies have demonstrated that microRNAs (miRs) serve important roles in mediating tumor initiation and progression. miR-454-3p has been found to be involved in the development of various human malignancies; however, little is known about the role of miR-454-3p in esophageal cancer. In the present study, the protein and gene expression levels of miR-454-3p in ESCA tissues and cells were downregulated compared with adjacent normal tissues and normal human esophageal epithelial cells. Additionally, miR-454-3p downregulation resulted in improved survival rates in patients with ESCA, and miR-454-3p overexpression significantly suppressed cell proliferation, migration and invasion and promoted apoptosis in four ESCA cell lines (EC9706, ECA109, TE-1 and TE-8). It was found that miR-454-3p overexpression inhibited the expression of insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) at the protein and mRNA expression levels. Furthermore, it was demonstrated that miR-454-3p inhibited ESCA cell proliferation, migration and apoptosis by targeting IGF2BP1 via the ERK and AKT signaling pathways in a subcutaneous xenograft tumor mouse model. These results showed that miR-454-3p functioned as an important tumor suppressor in ESCA by targeting IGFBP1. Therefore, miR-454-3p may be a novel prognostic biomarker and therapeutic target for patients with ESCA.

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“…At present, the overall 5-year survival rate of esophageal carcinoma is 45.7% [1]. Despite recent advances in minimally invasive oesophagectomy [2], there was no significant improvement in survival.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Local Recurrence Patterns of Postoperative Radiotherapy with Surgery Alone for Esophageal Carcinoma Patients

2021

International Journal of Surgery Oncology

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Background:We analyzed local regional recurrence patterns of thoracic esophageal carcinoma after three-field lymph node dissection (3-FLD) with and without postoperative radiotherapy, and assessed the postoperative radiation value for local control. Methods:The study reviewed 239 local recurrences of esophageal squamous cell carcinoma after 3-FLD from 2010 to 2018 in our hospital, retrospectively, and compared local regional recurrence patterns between surgery followed by radiotherapy (S+RT) and surgery alone (SA). Results:In 239 thoracic esophageal carcinomas that underwent curative surgery, the lymph node recurrence was the most common type of local recurrence for patients in both groups. The sequence of lymph node recurrence rate in both groups from highest to lowest was mediastinal, cervical, and abdominal. The recurrence rate of superior mediastinal lymph node in patients without radiotherapy was significantly higher than that in patients with radiotherapy (67.72% vs. 47.54%, x 2 = 7.615, P = 0.006). The recurrence rate of abdominal lymph node in the upper TEC was significantly lower than that in the middle and lower TEC (x 2 = 9.452, P = 0.009). The abdominal lymph node recurrence rate in patients with preoperative abdominal LNM was very significantly higher than that in patients without preoperative abdominal LNM (43.63% vs. 6.66%, P < 0.001). Conclusions:The dangerous lymph node recurrence regions included superior, middle mediastinum, and neck. Postoperative radiotherapy shows great value for patients in reducing superior mediastinal lymph node recurrence rate. The lower segment of thoracic esophageal carcinoma and preoperative abdominal lymph node metastasis, especially para-aortic lymph node metastasis, may be risk factors for abdominal lymph node recurrence.

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Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients

Abstract: ¶ Membership of the Termite Genome Working Group is listed in the Acknowledgments.

Cited by 39 publications

References 21 publications

Clinical, epidemiological, and diagnostic characteristics of esophageal carcinoma in a Pakistani population

Clinical, epidemiological, and diagnostic characteristics of esophageal carcinoma in a Pakistani population

MicroRNA‑454‑3p inhibits cell proliferation and invasion in esophageal cancer by targeting insulin‑like growth factor 2 mRNA‑binding protein 1

Comparison of Local Recurrence Patterns of Postoperative Radiotherapy with Surgery Alone for Esophageal Carcinoma Patients

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