Upper GI and Soft Tissue Unit, Division of Surgery, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Med J Aust. 2010 Nov 15;193(10):572-7. doi: 10.5694/j.1326-5377.2010.tb04064.x.
To document presenting symptoms, investigations and management for Australian patients with oesophageal adenocarcinoma (OAC), gastro-oesophageal junction adenocarcinoma (GOJAC) and oesophageal squamous cell carcinoma (OSCC).
DESIGN, SETTING AND PARTICIPANTS: Cross-sectional study of a population-based sample of 1100 Australian patients aged 18-79 years with histologically confirmed oesophageal cancer diagnosed in 2002-2005, using data from cancer registries and treatment centres, supplemented with clinical information collected through medical record review in 2006-2007 and mortality information collected in 2008.
Prevalence of primary symptoms, and staging investigations and treatment modalities used.
The primary presenting symptom was dysphagia, which was self-reported by 41%, 39% and 48% of patients with OAC, GOJAC and OSCC, respectively. Less common symptoms were reflux, chest pain, bleeding and weight loss. All patients underwent endoscopy, most had a staging computed tomography scan (OAC 93%, GOJAC 95% and OSCC 93%), and about half had positron emission tomography scans (OAC 51%, GOJAC 44% and OSCC 42%). Pretreatment tumour stage was reported in 25% of records, and could be derived from results of investigations in a further 23%, but the remaining half lacked sufficient information to ascribe a pretreatment stage. Curative treatments were attempted for 60% of OAC, 88% of GOJAC and 65% of OSCC patients. Surgery was performed on 52% of OAC, 83% of GOJAC and 41% of OSCC patients. About two-thirds of surgical patients received additional therapies.
With anticipated increases in oesophageal cancer incidence, the resources required to diagnose and manage patients with oesphageal cancer are also likely to rise. Our data provide a baseline from which to plan for the future care of patients with cancers of the oesophagus.
记录澳大利亚食管腺癌（OAC）、胃食管交界处腺癌（GOJAC）和食管鳞状细胞癌（OSCC）患者的临床表现、检查和治疗方法。
设计、设置和参与者：对 2002-2005 年间确诊的 1100 名年龄在 18-79 岁之间的澳大利亚人群进行了基于人群的样本的横断面研究，使用了来自癌症登记处和治疗中心的数据，并通过 2006-2007 年的病历回顾收集了临床信息，并在 2008 年收集了死亡率信息。
主要表现症状的患病率，以及使用的分期检查和治疗方式。
主要表现症状为吞咽困难，OAC、GOJAC 和 OSCC 患者分别有 41%、39%和 48%报告了该症状。不太常见的症状包括反流、胸痛、出血和体重减轻。所有患者都接受了内镜检查，大多数患者进行了分期计算机断层扫描（OAC 为 93%，GOJAC 为 95%，OSCC 为 93%），约有一半患者进行了正电子发射断层扫描（OAC 为 51%，GOJAC 为 44%，OSCC 为 42%）。25%的病历中报告了治疗前肿瘤分期，进一步的 23%的病历中可以推断出分期检查结果，但另一半病历缺乏足够的信息来确定治疗前的分期。60%的 OAC、88%的 GOJAC 和 65%的 OSCC 患者尝试了根治性治疗。52%的 OAC、83%的 GOJAC 和 41%的 OSCC 患者进行了手术。约三分之二的手术患者接受了额外的治疗。
随着食管癌症发病率的预期增加，诊断和治疗食管癌症患者所需的资源也可能增加。我们的数据为未来规划食管癌症患者的治疗提供了一个基线。
