Biniam Kidane1, Joanne Sulman2, Wei Xu3, Qin Quinn Kong3, Rebecca Wong4, Jennifer J Knox5, Gail E Darling6. 1. Division of Thoracic Surgery, University of Toronto, Toronto, Ontario, Canada; Divison of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada. 2. Divison of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada. 3. Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada. 4. Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada. 5. Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology, University of Toronto, Toronto, Ontario, Canada. 6. Division of Thoracic Surgery, University of Toronto, Toronto, Ontario, Canada; Divison of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada. Electronic address: gail.darling@uhn.on.ca.
Abstract
OBJECTIVE: Functional Assessment of Cancer Therapy-Esophagus is a health-related quality of life instrument validated in patients with esophageal cancer. It is composed of a general component and an esophageal cancer subscale. Our objective was to determine whether the baseline Functional Assessment of Cancer Therapy-Esophagus and esophageal cancer subscale scores are associated with survival in patients with stage II and III cancer of the gastroesophageal junction or thoracic esophagus. METHODS: Data from 4 prospective studies in Canadian academic hospitals were combined. These included consecutive patients with stage II and III esophageal cancer who received neoadjuvant therapy followed by surgery or chemoradiation/radiation alone. All patients completed baseline Functional Assessment of Cancer Therapy-Esophagus. Functional Assessment of Cancer Therapy-Esophagus and esophageal cancer subscale scores were dichotomized on the basis of median scores. Cox regression analyses were performed. RESULTS: There were 207 patients treated between 1996 and 2014. Mean age was 61 ± 10.6 years. Approximately 69.6% of patients (n = 144) had adenocarcinoma. All patients had more than 9 months of follow-up. In patients with stage II and III, 93 deaths were observed. When treated as continuous variables, baseline Functional Assessment of Cancer Therapy-Esophagus and esophageal cancer subscale were associated with survival with hazard ratios of 0.89 (95% confidence interval [CI], 0.81-0.96; P = .005) and 0.68 (95% CI, 0.56-0.82; P < .001), respectively. When dichotomized, they were also associated with survival with a hazard ratio of 0.58 (95% CI, 0.38-0.89; P = .01) and 0.43 (95% CI, 0.28-0.67; P < .001), respectively. CONCLUSIONS: In patients with stage II and III esophageal cancer being considered for therapy, higher baseline Functional Assessment of Cancer Therapy-Esophagus and esophageal cancer subscale were independently associated with longer survival, even after adjusting for age, stage, histology, and therapy received. Further study is needed, but Functional Assessment of Cancer Therapy-Esophagus may be useful as a prognostic tool to inform patient decision-making and patient selection criteria for studies.
OBJECTIVE: Functional Assessment of Cancer Therapy-Esophagus is a health-related quality of life instrument validated in patients with esophageal cancer. It is composed of a general component and an esophageal cancer subscale. Our objective was to determine whether the baseline Functional Assessment of Cancer Therapy-Esophagus and esophageal cancer subscale scores are associated with survival in patients with stage II and III cancer of the gastroesophageal junction or thoracic esophagus. METHODS: Data from 4 prospective studies in Canadian academic hospitals were combined. These included consecutive patients with stage II and III esophageal cancer who received neoadjuvant therapy followed by surgery or chemoradiation/radiation alone. All patients completed baseline Functional Assessment of Cancer Therapy-Esophagus. Functional Assessment of Cancer Therapy-Esophagus and esophageal cancer subscale scores were dichotomized on the basis of median scores. Cox regression analyses were performed. RESULTS: There were 207 patients treated between 1996 and 2014. Mean age was 61 ± 10.6 years. Approximately 69.6% of patients (n = 144) had adenocarcinoma. All patients had more than 9 months of follow-up. In patients with stage II and III, 93 deaths were observed. When treated as continuous variables, baseline Functional Assessment of Cancer Therapy-Esophagus and esophageal cancer subscale were associated with survival with hazard ratios of 0.89 (95% confidence interval [CI], 0.81-0.96; P = .005) and 0.68 (95% CI, 0.56-0.82; P < .001), respectively. When dichotomized, they were also associated with survival with a hazard ratio of 0.58 (95% CI, 0.38-0.89; P = .01) and 0.43 (95% CI, 0.28-0.67; P < .001), respectively. CONCLUSIONS: In patients with stage II and III esophageal cancer being considered for therapy, higher baseline Functional Assessment of Cancer Therapy-Esophagus and esophageal cancer subscale were independently associated with longer survival, even after adjusting for age, stage, histology, and therapy received. Further study is needed, but Functional Assessment of Cancer Therapy-Esophagus may be useful as a prognostic tool to inform patient decision-making and patient selection criteria for studies.
Authors: Alla Alghamedi; Gordon Buduhan; Lawrence Tan; Sadeesh Kumar Srinathan; Joanne Sulman; Gail Darling; Biniam Kidane Journal: Ann Transl Med Date: 2018-02
Authors: J J van Kleef; W P M Dijksterhuis; H G van den Boorn; M Prins; R H A Verhoeven; S S Gisbertz; M Slingerland; N Haj Mohammad; G-J Creemers; K J Neelis; J Heisterkamp; C Rosman; J P Ruurda; E A Kouwenhoven; L V van de Poll-Franse; M G H van Oijen; M A G Sprangers; H W M van Laarhoven Journal: Gastric Cancer Date: 2021-07-12 Impact factor: 7.701