Marianne C Kalff1, Eivind Gottlieb-Vedi, Rob H A Verhoeven, Hanneke W M van Laarhoven, Jesper Lagergren, Suzanne S Gisbertz, Sheraz R Markar, Mark I van Berge Henegouwen. 1. Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands School of Cancer and Pharmaceutical Sciences, King's College London, United Kingdom Department Surgery & Cancer, Imperial College London, United Kingdom.
Abstract
OBJECTIVE: This population-based study aimed to compare presentation, treatment allocation and survival of potentially curable esophageal cancer patients between Sweden and the Netherlands. SUMMARY OF BACKGROUND DATA: Identification of inter-country differences in treatment allocation and survival may be used for targeted esophageal cancer care improvement. METHODS: Nationwide datasets were acquired from a Swedish cohort study and the Netherlands Cancer Registry. Patients with potentially curable (cT1-T4a/Tx, cN0/+, cM0/x) esophageal adenocarcinoma or squamous cell carcinoma (SCC) diagnosed in 2011-2015 were included. Multivariable logistic regression provided odds ratios (OR) for treatment allocation, and multivariable Cox model provided hazard ratios (HR) for overall survival, all with 95% confidence intervals (CI), adjusted for age, sex, year, tumor sub-location and stage. RESULTS: Among 1980 Swedish and 7829 Dutch esophageal cancer patients, Swedish patients were older (71 vs 69 years, P <0.001) and had higher cT-stage (cT3: 49% vs 46%, P <0.001). After adjustment for confounders, Swedish patients were less frequently allocated to curative treatment (adenocarcinoma: OR=0.31, 95%CI 0.26-0.36; SCC: OR=0.28, 95%CI 0.22-0.36). Overall survival was lower in Swedish patients (adenocarcinoma: HR=1.36, 95%CI 1.27-1.46; SCC: HR=1.38, 95%CI 1.24-1.53), also when allocated to curative treatment (adenocarcinoma: HR=1.12, 95%CI 1.01-1.24; SCC: HR=1.34, 95%CI 1.14-1.59). CONCLUSION: Swedish patients with potentially curable esophageal cancer were less frequently allocated to curative treatment, and showed lower survival compared to Dutch patients. The less pronounced inter-country survival difference after curative treatment suggests that the overall survival difference could at least partly be due to relative undertreatment of Swedish patients. Shared curative treatment thresholds across Europe may help improve survival of esophageal cancer patients.
OBJECTIVE: This population-based study aimed to compare presentation, treatment allocation and survival of potentially curable esophageal cancerpatients between Sweden and the Netherlands. SUMMARY OF BACKGROUND DATA: Identification of inter-country differences in treatment allocation and survival may be used for targeted esophageal cancer care improvement. METHODS: Nationwide datasets were acquired from a Swedish cohort study and the Netherlands Cancer Registry. Patients with potentially curable (cT1-T4a/Tx, cN0/+, cM0/x) esophageal adenocarcinoma or squamous cell carcinoma (SCC) diagnosed in 2011-2015 were included. Multivariable logistic regression provided odds ratios (OR) for treatment allocation, and multivariable Cox model provided hazard ratios (HR) for overall survival, all with 95% confidence intervals (CI), adjusted for age, sex, year, tumor sub-location and stage. RESULTS: Among 1980 Swedish and 7829 Dutch esophageal cancerpatients, Swedish patients were older (71 vs 69 years, P <0.001) and had higher cT-stage (cT3: 49% vs 46%, P <0.001). After adjustment for confounders, Swedish patients were less frequently allocated to curative treatment (adenocarcinoma: OR=0.31, 95%CI 0.26-0.36; SCC: OR=0.28, 95%CI 0.22-0.36). Overall survival was lower in Swedish patients (adenocarcinoma: HR=1.36, 95%CI 1.27-1.46; SCC: HR=1.38, 95%CI 1.24-1.53), also when allocated to curative treatment (adenocarcinoma: HR=1.12, 95%CI 1.01-1.24; SCC: HR=1.34, 95%CI 1.14-1.59). CONCLUSION: Swedish patients with potentially curable esophageal cancer were less frequently allocated to curative treatment, and showed lower survival compared to Dutch patients. The less pronounced inter-country survival difference after curative treatment suggests that the overall survival difference could at least partly be due to relative undertreatment of Swedish patients. Shared curative treatment thresholds across Europe may help improve survival of esophageal cancerpatients.
Authors: Masaru Hayami; Nelson Ndegwa; Mats Lindblad; Gustav Linder; Jakob Hedberg; David Edholm; Jan Johansson; Jesper Lagergren; Lars Lundell; Magnus Nilsson; Ioannis Rouvelas Journal: Ann Surg Oncol Date: 2022-06-25 Impact factor: 4.339
Authors: Anna Junttila; Olli Helminen; Mika Helmiö; Heikki Huhta; Raija Kallio; Vesa Koivukangas; Arto Kokkola; Simo Laine; Elina Lietzen; Sanna Meriläinen; Vesa-Matti Pohjanen; Tuomo Rantanen; Ari Ristimäki; Jari V Räsänen; Juha Saarnio; Eero Sihvo; Vesa Toikkanen; Tuula Tyrväinen; Antti Valtola; Joonas H Kauppila Journal: Ann Surg Oncol Date: 2022-08-25 Impact factor: 4.339
Authors: Magnus Nilsson; Halla Olafsdottir; Gabriella Alexandersson von Döbeln; Fernanda Villegas; Giovanna Gagliardi; Mats Hellström; Qiao-Li Wang; Hemming Johansson; Val Gebski; Jakob Hedberg; Fredrik Klevebro; Sheraz Markar; Elizabeth Smyth; Pernilla Lagergren; Ghazwan Al-Haidari; Lars Cato Rekstad; Eirik Kjus Aahlin; Bengt Wallner; David Edholm; Jan Johansson; Eva Szabo; John V Reynolds; C S Pramesh; Naveen Mummudi; Amit Joshi; Lorenzo Ferri; Rebecca Ks Wong; Chris O'Callaghan; Jelena Lukovic; Kelvin Kw Chan; Trevor Leong; Andrew Barbour; Mark Smithers; Yin Li; Xiaozheng Kang; Feng-Ming Kong; Yin-Kai Chao; Tom Crosby; Christiane Bruns; Hanneke van Laarhoven; Mark van Berge Henegouwen; Richard van Hillegersberg; Riccardo Rosati; Guillaume Piessen; Giovanni de Manzoni; Florian Lordick Journal: Front Oncol Date: 2022-07-13 Impact factor: 5.738