BACKGROUND: We investigated temporal trends in treatment, and factors influencing treatment receipt and survival, for upper gastrointestinal cancers in routine community-based clinical practice. PATIENTS AND METHODS: Oesophageal and gastric-cardia cancers, diagnosed during the period 1994-2001, were sourced from the National Cancer Registry (Ireland). Analysis was by Joinpoint regression and multivariate logistic and Cox models. RESULTS: Thirty-five percent of patients received surgery, 35% radiotherapy and 24% chemotherapy. Over time chemo- and radiotherapy receipt increased significantly, whilst surgery decreased. Treatment patterns varied by tumour site, histology and stage. Older and/or unmarried patients were significantly less likely to receive treatment. Among surgically treated patients, those aged 70+ had higher mortality. Among both surgical and non-surgical patients, those receiving chemotherapy or radiotherapy had a modest, short-term, survival benefit. CONCLUSIONS: The use of adjuvant therapies is increasing in routine practice. After adjusting for clinical factors, patient-related factors predicted treatment and mortality. Improving equity in gastrointestinal cancer treatment may help improve survival.
BACKGROUND: We investigated temporal trends in treatment, and factors influencing treatment receipt and survival, for upper gastrointestinal cancers in routine community-based clinical practice. PATIENTS AND METHODS: Oesophageal and gastric-cardia cancers, diagnosed during the period 1994-2001, were sourced from the National Cancer Registry (Ireland). Analysis was by Joinpoint regression and multivariate logistic and Cox models. RESULTS: Thirty-five percent of patients received surgery, 35% radiotherapy and 24% chemotherapy. Over time chemo- and radiotherapy receipt increased significantly, whilst surgery decreased. Treatment patterns varied by tumour site, histology and stage. Older and/or unmarried patients were significantly less likely to receive treatment. Among surgically treated patients, those aged 70+ had higher mortality. Among both surgical and non-surgical patients, those receiving chemotherapy or radiotherapy had a modest, short-term, survival benefit. CONCLUSIONS: The use of adjuvant therapies is increasing in routine practice. After adjusting for clinical factors, patient-related factors predicted treatment and mortality. Improving equity in gastrointestinal cancer treatment may help improve survival.
Authors: Tej D Azad; Aadel A Chaudhuri; Penny Fang; Yawei Qiao; Mohammad S Esfahani; Jacob J Chabon; Emily G Hamilton; Yi D Yang; Alex Lovejoy; Aaron M Newman; David M Kurtz; Michael Jin; Joseph Schroers-Martin; Henning Stehr; Chih Long Liu; Angela Bik-Yu Hui; Viren Patel; Dipen Maru; Steven H Lin; Ash A Alizadeh; Maximilian Diehn Journal: Gastroenterology Date: 2019-11-09 Impact factor: 22.682
Authors: Stefan Münch; Christine Heinrich; Daniel Habermehl; Markus Oechsner; Stephanie E Combs; Marciana-Nona Duma Journal: Eur J Med Res Date: 2017-07-06 Impact factor: 2.175
Authors: Georgios Lyratzopoulos; Josephine M Barbiere; Chetna Gajperia; Michael Rhodes; David C Greenberg; Karen A Wright Journal: BMC Health Serv Res Date: 2009-12-15 Impact factor: 2.655