Y S Mao1, S G Gao1, Q Wang2, X T Shi3, Y Li4, W W Gao5, F S Guan6, X F Li7, Y T Han8, Y Y Liu9, J F Liu10, K Zhang11, S Y Liu12, X N Fu13, W T Fang14, L Q Chen15, Q C Wu16, G M Xiao17, K N Chen18, G G Jiao19, S J Zhang20, W M Mao21, T H Rong22, J H Fu22, L J Tan2, C Chen23, S D Xu24, S P Guo25, Z T Yu26, J Hu27, Z D Hu28, Y K Yang1, N N Ding1, D Yang1, J He1. 1. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. 2. Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China. 3. Department of Thoracic Surgery, Anyang Cancer Hospital, Anyang 455000, China. 4. Department of Thoracic Surgery, Henan Cancer Hospital, Zhengzhou 450003, China. 5. Department of Thoracic Surgery, Linzhou Renmin Hospital, Linzhou 456550, China. 6. Department of Thoracic Surgery, Linzhou Cancer Hospital, Linzhou 456550, China. 7. Department of Thoracic Surgery, affiliated Tandu Hospital of the Fourth Military University, Xian 710038, China. 8. Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu 610041, China. 9. Department of Thoracic Surgery, Liaoning Cancer Hospital, Shenyang 110042, China. 10. Department of Thoracic Surgery, the Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China. 11. Department of Thoracic Surgery, Jining Renmin Hospital, Jining 272001, China. 12. Department of Thoracic Surgery, Fujian Cancer Hospital, Fujian Medical University, Fuzhou 350014, China. 13. Department of Thoracic Surgery, Tongji Hospital, Tongji University, Wuhan 430030, China. 14. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai 200030, China. 15. Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China. 16. Department of Thoracic Surgery, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China. 17. Department of Thoracic Surgery, Hunan Cancer Hospital, Changsha 410000, China. 18. Department of Thoracic Surgery, Beijing Cancer Hospital, Beijing University, Beijing 100142, China. 19. Department of Thoracic Surgery, Linzhou Esophageal Cancer Hospital, Linzhou 456592, China. 20. Department of Thoracic Surgery, Jiangsu Renmin Hospital, Nanjing 210029, China. 21. Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China. 22. Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China. 23. Department of Thoracic Surgery, the Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, China. 24. Department of Thoracic Surgery, Heilongjiang Cancer Hospital, Harbin 150081, China. 25. Department of Thoracic Surgery, Shanxi Cancer Hospital, Taiyuan 030001, China. 26. Department of Thoracic Surgery, Tianjin Cancer Hospital, Tianjin 300060, China. 27. Department of Thoracic Surgery, First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China. 28. Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing 210009, China.
Abstract
Objective: To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China. Methods: A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014. Results: Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively. Conclusions: The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.
Objective: To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China. Methods: A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014. Results: Complete data of 8 181 cases of esophageal cancerpatients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively. Conclusions: The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancerpatients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.
Entities:
Keywords:
Data analysis; Epidemiological characteristics; Esophageal neoplasms; Surgical treatment
Authors: Long Zhang; Jinchen Shao; Zhichao Liu; Jie Pan; Bin Li; Yang Yang; Yi He; Yuchen Han; Zhigang Li Journal: Ann Surg Oncol Date: 2021-08-23 Impact factor: 5.344