Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Ann Surg Oncol. 2022 May;29(5):2805-2811. doi: 10.1245/s10434-022-11416-4. Epub 2022 Feb 21.
It is unknown whether the survival of patients cured of esophageal cancer differs from that of the corresponding background population. This nationwide and population-based cohort study included all patients who survived for at least 5 years after surgery for esophageal cancer in Sweden between 1987 and 2015, with follow-up throughout 2020. Relative survival rates with 95% confidence intervals (95% CI) were calculated by dividing the observed with the expected survival. The expected survival was assessed from the entire Swedish population of the corresponding age, sex, and calendar year. Yearly relative survival rates were calculated between 6 and 10 years postoperatively. Among all 762 participants, the relative survival was initially similar to the background population (96.1%, 95% CI 94.3-97.9%), but decreased each following postoperative year to 83.5% (95% CI 79.5-87.6%) by year 10. The drop in relative survival between 6 and 10 years was more pronounced in participants with a history of squamous cell carcinoma [from 94.5% (95% CI 91.2-97.8%) to 70.8% (95% CI 64.0-77.6%)] than in those with adenocarcinoma [from 96.9% (95% CI 94.8-99.0%) to 91.5% (95% CI 86.6-96.3%)], and in men [from 96.0% (95% CI 93.8-98.1%) to 81.8% (95% CI 76.8-86.8%)] than in women [from 96.4% (95% CI 93.4-99.5%) to 88.1% (95% CI 81.5-94.8%)]. No major differences were found between age groups. In conclusion, esophageal cancer survivors had a decline in survival between 6 and 10 years after surgery compared with the corresponding general population, particularly those with a history of squamous cell carcinoma of the esophagus and male sex.
目前尚不清楚治愈食管癌的患者的生存率是否与相应的基础人群不同。这项全国性和基于人群的队列研究纳入了 1987 年至 2015 年间在瑞典接受手术治疗后至少存活 5 年的所有食管癌患者，并随访至 2020 年。通过将观察到的生存率与预期生存率相除，计算出 95%置信区间（95%CI）的相对生存率。预期生存率是根据相应年龄、性别和年份的整个瑞典人群评估得出的。术后 6 至 10 年每年计算相对生存率。在所有 762 名参与者中，最初的相对生存率与基础人群相似（96.1%，95%CI 94.3-97.9%），但在术后每年下降至 10 年后的 83.5%（95%CI 79.5-87.6%）。在有鳞状细胞癌病史的参与者中，6 至 10 年期间相对生存率的下降更为明显[从 94.5%（95%CI 91.2-97.8%）降至 70.8%（95%CI 64.0-77.6%）]，而在腺癌患者中，从 96.9%（95%CI 94.8-99.0%）降至 91.5%（95%CI 86.6-96.3%），在男性中，从 96.0%（95%CI 93.8-98.1%）降至 81.8%（95%CI 76.8-86.8%），而在女性中，从 96.4%（95%CI 93.4-99.5%）降至 88.1%（95%CI 81.5-94.8%）。在年龄组之间未发现重大差异。总之，与相应的普通人群相比，食管癌幸存者在手术后 6 至 10 年内生存率下降，特别是那些有食管鳞状细胞癌病史和男性。
