Deng Wei, Yu Rong, Yang Zhao, Dong Xin, Wang Weihu
Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, China.
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Sassoon Road, Hong Kong, China.
Ann Transl Med. 2021 Jan;9(2):102. doi: 10.21037/atm-20-2798.
This study aims to investigate the causes of death in patients with esophageal cancer (EC) and report reliable and accurate estimates of adjusted conditional overall survival (COS).
We retrieved data on patients aged 18 years or older who were diagnosed with EC between 1975 and 2016 from the Surveillance Epidemiology End Results (SEER) registry. We estimated COS by using an inverse probability weighting method to adjust for the available covariates. Linear trends were analyzed via a weighted linear regression.
A total of 40,142 confirmed patients were included in the final analysis. Of these, 20,971 were diagnosed with esophageal squamous cell carcinoma, and 19,171 were diagnosed with esophageal adenocarcinoma. EC was the leading cause of death, followed by heart disease (5.2%), stomach cancer (3.2%), and other diseases (2.9%). Five-year adjusted COS, given that patients had already survived 36 months was improved from 0.50 to 0.87 (P<0.001) in comparison with the 5-year conventional overall survival. As the survival time increased from 0 to 48 months, the 5-year adjusted COS improved significantly. The adjusted conditional EC-specific survival also showed similar trends.
For patients with EC who had survived over time, the 5-year adjusted COS and the conditional EC-specific survival improved dramatically. Other causes of death in EC patients should also be considered.
本研究旨在调查食管癌（EC）患者的死亡原因，并报告调整后的条件总体生存率（COS）的可靠准确估计值。
我们从监测、流行病学和最终结果（SEER）登记处检索了1975年至2016年间诊断为EC的18岁及以上患者的数据。我们使用逆概率加权法估计COS，以调整可用的协变量。通过加权线性回归分析线性趋势。
共有40142例确诊患者纳入最终分析。其中，20971例被诊断为食管鳞状细胞癌，19171例被诊断为食管腺癌。EC是主要死因，其次是心脏病（5.2%）、胃癌（3.2%）和其他疾病（2.9%）。与5年传统总生存率相比，患者已存活36个月时的5年调整后COS从0.50提高到0.87（P<0.001）。随着生存时间从0增加到48个月，5年调整后COS显著提高。调整后的条件EC特异性生存率也显示出类似趋势。
对于长期存活的EC患者，5年调整后COS和条件EC特异性生存率显著提高。还应考虑EC患者的其他死亡原因。
