Dataset Information

Cause of death in patients diagnosed with esophageal cancer in Sweden: a population-based study.

ABSTRACT:

Background

Esophageal cancer carries a poor prognosis with an overall 5-year survival of less than 20%. However, the causes of death in patients with esophageal cancer have not been well described.

Methods

This nationwide, population-based cohort study included 18 229 esophageal cancer patients who were diagnosed between 1961 and 2014 in Sweden. We assessed the distribution of main causes of death in patients with esophageal cancer and used competing-risks regression to compare the cause-specific risks of death across sexes, ages at diagnosis, and calendar periods of diagnosis.

Results

A total of 16 938 (92.9%) patients died during follow-up. Esophageal cancer accounted for 79.5% of all reported deaths. Other major causes of death were non-esophageal cancers (9.8%), ischemic heart disease or cerebrovascular disease (4.2%) and respiratory diseases (1.3%). Female patients had a lower risk of death from esophageal cancer (sub-hazard ratio [SHR]=0.90, 95% confidence interval [CI]: 0.87, 0.94), which was more pronounced in patients with squamous cell carcinoma (SHR=0.85, 95% CI: 0.81, 0.89). Risks of death from esophageal cancer and other cancers in patients who were diagnosed in more recent calendar periods were lower than in those diagnosed in earlier periods.

Conclusions

Patients diagnosed with esophageal cancer are more likely to die from this cancer than from other causes. However, these patients also face considerable risk of death from other cancers, ischemic heart disease, cerebrovascular disease, and respiratory diseases. These common causes of death should be taken into consideration in esophageal cancer management.

SUBMITTER: Xie SH

PROVIDER: S-EPMC5584290 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Publications

Cause of death in patients diagnosed with esophageal cancer in Sweden: a population-based study.

Xie Shao-Hua SH Wahlin Karl K Lagergren Jesper J

Oncotarget 20170211 31

<h4>Background</h4>Esophageal cancer carries a poor prognosis with an overall 5-year survival of less than 20%. However, the causes of death in patients with esophageal cancer have not been well described.<h4>Methods</h4>This nationwide, population-based cohort study included 18 229 esophageal cancer patients who were diagnosed between 1961 and 2014 in Sweden. We assessed the distribution of main causes of death in patients with esophageal cancer and used competing-risks regression to compare th ...[more]

PMID: 28881689

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Project description:BackgroundEsophageal cancer is one of the most common cancer types, with its most common distant metastatic site being the lung. Currently, population-based data regarding the proportion and prognosis of patients with esophageal cancer with lung metastases (ECLM) at the time of diagnosis is insufficient. Therefore, we aimed to determine the proportion of patients with ECLM at diagnosis, as well as to investigate the prognostic parameters of ECLM.MethodsThis population-based observational study obtained data from the Surveillance, Epidemiology, and End Results (SEER) database registered between 2010 and 2016. Multivariable logistic regression was performed to identify predictors of the presence of ECLM at diagnosis. Multivariable Cox regression and competing risk analysis were used to assess prognostic factors in patients with ECLM. Median survival was estimated using Kaplan-Meier curves.ResultsOf 10,965 patients diagnosed with esophageal cancer between 2010 and 2016, 713 (6.50%) presented with initial lung metastasis at diagnosis. Lung metastasis represented 27.15% of all cases with metastatic disease to any distant site. Considering all patients with esophageal cancer, multivariable logistic regression indicated that pathology grade, pathology type, T staging, N staging, race, and number of extrapulmonary metastatic sites were predictive factors for the occurrence of lung metastases at diagnosis. The median survival time of patients with ECLM was 4.0 months. Patients receiving chemotherapy or chemoradiotherapy had the longest median overall survival, 7.0 months. Multivariable Cox regression indicated that age, histology type, T2 staging, number of extrapulmonary metastatic sites, and treatment (chemotherapy, radiotherapy, or chemoradiotherapy) were independent predictors for overall survival (OS). Multivariable competing risk analysis determined that age, number of extrapulmonary metastatic sites, and treatment were independent predictors for esophageal cancer-specific survival (CSS).ConclusionThe findings of this study may provide important information for the early diagnosis of ECLM, as well as aid physicians in choosing appropriate treatment regimens for these patients.

Project description:BackgroundThe occurrence of cardiovascular events is a major cause of death in patients with cancer. Small studies have documented a connection between specific brain alterations and autonomic cardiac dysfunctions, possibly resulting in a worse prognosis. We aimed to refine the knowledge of fatal cardiac events in patients with brain metastasis (BM).MethodsWe performed a Surveillance, Epidemiology, and End Results SEER registry-based investigation (timeline: 2010-2016) and extracted all the advanced patients who had experienced fatal cardiac outcomes. Populations were compared according to the presence or not BM. Kaplan-Meier (KM) methodology was used for survival analysis and a multivariate model was developed by adjusting for multiple possible confounders.ResultsMost related BM and cardiac death were observed at the site of lung cancer (81.4%). We extracted 3187 patients with lung cancer site, including 417 patients who had experienced fatal heart-specific with a history of BM, which is considered a BM group. The second group of heart-specific death included 2770 patients was stated as a non-BM group. Patients who had experienced heart-specific death in the BM group were predominately male, right side, upper site, and non-small type (62.11%, 54.92%, 51.56%, 69.78%), respectively. The survival outcomes between BM and the non- BM was significantly prominent (p = 0.003; median: 2 months vs. 3 months).The negative prognostic independent significance of heart-fatal events was confirmed after adjusting for multiple variables (HR = 0.76, CI = 0.68-84, p < 0.0001). The metastatic liver site was significantly associated with poorer survival rates (HR = 0.68; CI = 0.52-0.88, p = 0.005). We revealed a possible connection between the brain and heart functions.ConclusionsThe prognosis of heart-specific death patients in BM is unfavorable compared to non-BM settings in lung cancer. We may be at the gates of a new field of neurocardiooncology.

Dataset Information

Cause of death in patients diagnosed with esophageal cancer in Sweden: a population-based study.

Background

Methods

Results

Conclusions

Publications

Cause of death in patients diagnosed with esophageal cancer in Sweden: a population-based study.

Similar Datasets

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