Literature DB >> 16518284

Trends in incidence and management of esophageal adenocarcinoma in a well-defined population.

Côme Lepage1, Anne-Marie Bouvier, Sylvain Manfredi, Olivier Coatmeur, Nicolas Cheynel, Jean Faivre.   

Abstract

OBJECTIVES: Little epidemiological data is available concerning esophageal adenocarcinomas in France. The aim of this study was to study epidemiological characteristics and management of esophageal adenocarcinoma in a well-defined population.
METHODS: Data were collected by the Burgundy Digestive Cancer Registry covering a population of 1 052 000, over a 28-year period (1976-2001). Incidence, treatment and stage at diagnosis were noted. Univariate and multivariate analysis of survival was performed.
RESULTS: Age standardized incidence rates were 1.60/100,000 in men and 0.15/100,000 in women. The mean increase in incidence rates by 5-year periods were respectively + 68.1% (P<0.001) and + 97.4% (P<0.001). Overall, 69.9% of the cancers were located in the lower third of the esophagus. Surgical resection was performed in 32.1% of patients. Among the surgical patients, the tumor was limited to the esophageal wall in 11.4%, lymph node metastases were present in 18.1% and non-resectable distant metastases in 70.5%. There was no improvement of stage at diagnosis over time. Survival rates were 14.4% at 3 years and 9.2% at 5 years. Five-year survival rates varied from 38.4% for cases limited to the esophageal wall to 1.8% for metastatic and non resectable cases. Stage at diagnosis was the only significant prognostic factor in the multivariate analysis.
CONCLUSION: Esophageal adenocarcinomas are rare cancers characterized by a sharp rise in incidence over the past years in France. Stage at diagnosis and prognosis are worse than reported in hospital statistics.

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Year:  2005        PMID: 16518284     DOI: 10.1016/s0399-8320(05)82218-3

Source DB:  PubMed          Journal:  Gastroenterol Clin Biol        ISSN: 0399-8320


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