Predictors of survival among patients diagnosed with adenocarcinoma of the esophagus and gastroesophageal junction

Thrift, Aaron P., Nagle, Christina M., Fahey, Paul P., Smithers, Bernard M., Watson, David I. and Whiteman, David C. (2012) Predictors of survival among patients diagnosed with adenocarcinoma of the esophagus and gastroesophageal junction. Cancer Causes and Control, 23 4: 555-564. doi:10.1007/s10552-012-9913-1

Author Thrift, Aaron P.
Nagle, Christina M.
Fahey, Paul P.
Smithers, Bernard M.
Watson, David I.
Whiteman, David C.
Title Predictors of survival among patients diagnosed with adenocarcinoma of the esophagus and gastroesophageal junction
Journal name Cancer Causes and Control   Check publisher's open access policy
ISSN 0957-5243
Publication date 2012-04-01
Sub-type Article (original research)
DOI 10.1007/s10552-012-9913-1
Open Access Status Not Open Access
Volume 23
Issue 4
Start page 555
End page 564
Total pages 10
Place of publication Dordrecht, Netherlands
Publisher Springer Netherlands
Language eng
Abstract Neoadjuvant chemotherapy improves prognosis of patients with locally advanced gastroesophageal adenocarcinoma. The aim of this study was to identify predictors for postoperative survival following neoadjuvant therapy. These could be useful in deciding about postoperative continuation of chemotherapy.
Formatted abstract
Purpose: Patients diagnosed with esophageal adenocarcinoma (EAC) or gastroesophageal junction adenocarcinoma (GEJAC) have poor survival. We investigated the possible influence of pre-morbid lifestyle factors on survival for these lethal cancers.
This study included a population-based cohort of patients with EAC (n = 362) and GEJAC (n = 421) tumors. Detailed information about demographic and lifestyle factors was obtained around the time of diagnosis, and deaths were identified using the National Death Index. Hazard ratios (HR) and 95% confidence intervals (95% CI) were calculated from Cox proportional hazards models, adjusted for age, sex, pre-treatment American Joint Committee on Cancer tumor stage, treatment and presence of comorbidities.
Results: Median follow-up for mortality was 6.4 years. Five-year survival rates were 27 and 33% for EAC and GEJAC, respectively. As expected, tumor and treatment characteristics were the strongest predictors of survival for both cancer sites. Among patients diagnosed with GEJAC tumors, those who were older (≥70 years, adjusted HR = 1.70, 95% CI 1.24-2.32) and those who reported being current smokers (adjusted HR = 1.45, 95% CI 1.02-2.06) fared worse. Other lifestyle factors putatively associated with risk of developing GEJAC including body mass index, gastroesophageal reflux symptoms, alcohol, and use of non-steroidal anti-inflammatory drugs were not associated with survival. Likewise, after adjusting for stage and treatment, no clear associations were detected between lifestyle factors and survival among patients with EAC tumors. We found similar results for analyses restricted to patients treated surgically.
Conclusions: Overall, our data suggest that lifestyle factors do not appear to unduly influence survival for these cancers.
Keyword Esophageal adenocarcinoma
Gastroesophageal junction
Lifestyle factors
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: School of Public Health Publications
Official 2013 Collection
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