Patient and tumour characteristics as prognostic markers for oesophageal cancer: a retrospective analysis of a cohort of patients at Groote Schuur Hospital

• Published in: European journal of cardio-thoracic surgery 2016-02, Vol.49 (2), p.629-634
• Main Authors: Dandara, Collet, Robertson, Barbara, Dzobo, Kevin, Moodley, Loven, Parker, M. Iqbal
• Format: Article
• Language: English
• Subjects: Adult; African Continental Ancestry Group; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - ethnology; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - therapy; Combined Modality Therapy; Esophageal Neoplasms - diagnosis; Esophageal Neoplasms - ethnology; Esophageal Neoplasms - mortality; Esophageal Neoplasms - therapy; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Prognosis; Retrospective Studies; South Africa - epidemiology
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezv135

OBJECTIVES In addition to the high incidence of squamous carcinoma of the oesophagus among South African men, the neoplasm is also characterized by an exceptionally latent course and poor prognosis. The aim of this study was to review a cohort of patients with carcinoma of the oesophagus presenting to the Groote Schuur Hospital, Cape Town and evaluate patient and tumour characteristics for their role as prognostic markers for survival. METHODS Information on patients was extracted from a database established and maintained over a 30-year period. Information for the analysis included patient demographics, clinical symptoms at presentation, tumour characteristics and treatment decisions. Statistical analyses were performed using GraphPad Prism 5 applying chi-square and Kaplan–Meier tests. RESULTS Data were available on 1868 patients. The majority of patients were Black African men and the predominant histology was squamous cell carcinoma. There were significant differences (P < 0.05) in the survival of patients with respect to race (P < 0.001), performance status (P < 0.001), weight loss (P = 0.001) and prior tuberculosis diagnosis (P = 0.007). Tumour characteristics that were significantly associated with survival were histological type, tumour size and site. Gender, prior cancer, smoking status and tumour-related pain did not show significant association with survival in patients with oesophageal cancer. Only 19.8% of the patients were candidates for potentially curative treatment. CONCLUSIONS This analysis shows that there are prominent patient and tumour characteristics that are significantly associated with survival with respect to oesophageal carcinoma. The inclusion of these factors in the initial assessment of patients may assist with appropriate treatment decisions.