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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

Title
Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients
Authors
Jung, Hye-KyungTae, Chung HyunLee, Hye-AhLee, HyukChoi, Kee DonPark, Jun ChulKwon, Joong GooChoi, Yoon JinHong, Su JinSung, JaekyuChung, Woo ChulKim, Ki BaeKim, Seung YoungSong, Kyung HoPark, Kyung SikJeon, Seong WooKim, Byung-WookRyu, Han SeungLee, Ok-JaeBaik, Gwang HoKim, Yong SungJung, Hwoon-YongKorean Coll Helicobacter Upper
Ewha Authors
정혜경태정현이혜아
SCOPUS Author ID
정혜경scopus; 이혜아scopus
Issue Date
2020
Journal Title
PLOS ONE
ISSN
1932-6203JCR Link
Citation
PLOS ONE vol. 15, no. 4
Publisher
PUBLIC LIBRARY SCIENCE
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Using data from the real world to solve clinical questions that cannot be answered using data from clinical trials is attracting more attention. Clinical outcomes for patients with esophageal cancer in a real-world setting might be different from data in randomized controlled trials. This study aimed to provide real world data on treatment and prognosis in Korean patients with esophageal cancer. This retrospective cancer cohort included newly diagnosed cases of esophageal cancer at 19 tertiary hospitals between January 1, 2005 and December 31, 2017. Cancer staging was defined according to the 7th edition of the American Joint Committee on Cancer criteria. We identified 6,354 patients with newly diagnosed esophageal cancer (mean age: 64.9 +/- 9.0 years, 96.9% squamous cell carcinoma). The proportion of early esophageal cancer increased from 24.7% in 2005 to 37.2% in 2015 (p<0.001). Among all cases, surgery alone was 31.3%, followed by definitive concurrent chemoradiotherapy (CCRT) (27.0%), neoadjuvant therapy (12.4%), adjuvant therapy (11.1%), and endoscopic resection (5.8%). The 5-year overall survival rate was 45.7 +/- 0.7%. Endoscopic resection provided similar median survival relative to surgery for stage Ia cases. Among stage II-III cases, definitive CCRT was associated with poorer survival than neoadjuvant or adjuvant therapy, although there was no survival difference between neoadjuvant and adjuvant therapy. Early esophageal cancer is gradually becoming more common and endoscopic resection provided similar long-term survival relative to surgery. Surgery with combined therapy provided better survival in locally advanced esophageal cancer, relative to definitive CCRT.
DOI
10.1371/journal.pone.0231456
Appears in Collections:
의과대학 > 의학과 > Journal papers
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