Patterns of care and outcomes in oesophageal cancer

Dig Liver Dis. 2018 Nov;50(11):1238-1243. doi: 10.1016/j.dld.2018.07.011. Epub 2018 Jul 20.


Background: The optimal treatment for oesophageal cancer is a matter of debate. The aim of this study was to describe patterns of care and survival in a well-defined population for squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the oesophagus.

Design: Data were provided by the Digestive Cancer Registry of Burgundy (France). Recurrence, excess mortality and net survival were calculated.

Results: Among non-metastatic patients, the proportion of patients resected for cure decreased between 2004 and 2013 from 16% to 9% for SCC and 48% to 22% for AC. The administration of chemoradiation increased from 45 to 53% for SCC and 21 to 30% for AC. A complete clinical response to chemoradiation was reported in 40% of the patients. Five-year net survival did not vary according to histology. It was 55% in the selected group of patients resected for cure, 44% in patients treated with chemoradiation with a complete clinical response. In multivariate analysis, treatment modality only was associated with survival. In metastatic patients, 3-year net survival was 14% for those treated with chemoradiation.

Conclusion: Chemoradiation has become the most frequently administered treatment. Cancelling or postponing surgery after chemoradiation with complete response should be assessed by a randomized clinical trial.

Keywords: Chemoradiation; Oesophageal cancer; Outcomes; Population-based cancer registry; Surgery.

Publication types

  • Multicenter Study

MeSH terms

  • Adenocarcinoma / mortality*
  • Adenocarcinoma / therapy*
  • Aged
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / therapy*
  • Esophagus / pathology
  • Female
  • France / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local / epidemiology
  • Registries
  • Surgical Procedures, Operative
  • Survival Rate
  • Time Factors
  • Treatment Outcome