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Changes in Age, Stage Distribution, and Survival of Patients with Esophageal Adenocarcinoma over Three Decades in the United States

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Our aim was to evaluate the changes in age, stage distribution, and overall survival (OS) of patients with esophageal adenocarcinoma (EAC) over time.

Methods

Patients from the Surveillance, Epidemiology, and End Results (SEER) database aged ≥20 with invasive EAC, diagnosed from 1973–2003 were reviewed. Survival follow-up ended in 2006.

Results

There were 11,620 patients; 6580 (57%) aged ≥65. The stage distribution was 22%, 35%, and 43% for localized, regional, and distant metastasis for patients aged <65, and 33%, 33%, and 34% for patients aged ≥65. The number of patients ≥65 years with localized stage increased over time. Three-year OS for localized, regional, and distant disease increased from 19%, 10%, and 1% in 1973–1976, to 34%, 13%, and 2% in 1987–1991, and to 45%, 25%, and 4% in 2002–2003 (P < 0.001). A sub-analysis of 5475 patients from 1988–2002 showed better survival for patients with esophagectomy for all stages. Three-year OS for 2074 patients with esophagectomy improved every 5 years from 1988–2002 (39%, 43% to 54%, P < 0.001). Stratified by stage, year and esophagectomy status, patients aged <65 had better survival compared to patients aged ≥65 (P < 0.001).

Conclusions

There has been a substantial improvement in overall survival among patients with invasive EAC over the last 3 decades. Patients receiving esophagectomy had longer survival. Survival with esophagectomy improved in each time period. Although younger EAC patients were diagnosed at more advanced stages over time, they had better survival.

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Acknowledgment

We thank Dr. Sheri Skinner and Marika Stepankiw for editorial assistance.

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Authors and Affiliations

  1. Division of Oncology, Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, TX, USA

    Putao Cen MD & Robert J. Amato DO

  2. Department of Cardiothoracic and Vascular Surgery, The University of Texas Medical School at Houston, Houston, TX, USA

    Farzaneh Banki MD, Kamal Khalil & Larry R. Kaiser MD

  3. Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA

    Lee Cheng MD

  4. Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA

    Xianglin L. Du MD, PhD

  5. Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, TX, USA

    Michael Fallon MD

Authors
  1. Putao Cen MD
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  2. Farzaneh Banki MD
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  3. Lee Cheng MD
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  4. Kamal Khalil
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  5. Xianglin L. Du MD, PhD
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  7. Robert J. Amato DO
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Correspondence to Putao Cen MD.

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Cen, P., Banki, F., Cheng, L. et al. Changes in Age, Stage Distribution, and Survival of Patients with Esophageal Adenocarcinoma over Three Decades in the United States. Ann Surg Oncol 19, 1685–1691 (2012). https://doi.org/10.1245/s10434-011-2141-1

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  • DOI: https://doi.org/10.1245/s10434-011-2141-1

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