Staging and survival in esophageal cancer

BACKGROUND: Esophageal cancer worldwide is the eighth and sixth most common cancer in terms of incidence and mortality, respectively. Early diagnosis and clinical staging of the tumor, followed by standard treatment and the surgeon's experience, are essential for better patient survival. OBJECTIVE: The objective of this study was to evaluate the staging and survival of patients with esophageal cancer undergoing treatment in a low-volume hospital. PATIENTS AND METHODS: A retrospective, hospital-based study was conducted to analyze survival, clinical staging and pos-toperative death rates. Survival analysis was performed using the Kaplan-Meier method and log-Rank test with 5 percent significant level. RESULTS: Ninety-nine cases of squamous cell carcinoma of the esophagus were analyzed: 77 males (77.8 percent) and 22 females (22.2 percent). Most of the patients (68; 68.7 percent) were above 55 years of age. The standard treatment for esophageal cancer at the time of the study was surgical: esophagectomy with lymphadenectomy. Thirty-seven patients (37.4 percent) were submitted to surgical curative treatment and 62 (62.6 percent) to palliative care. For patients at initial stages of the disease, overall 1-year survival was 39 percent, with rates of 23 percent at 2 years and 17 percent in the third year. For advanced stages, survival ranged from 26.9 percent in the first year to 12.4 percent in the second year and 6.4 percent in the third year. CONCLUSION: Survival in patients with esophageal cancer was better in the initial stages in comparison with advanced stages. (AU)