Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients.
Using data from the real world to solve clinical questions that cannot be answered using data from clinical trials is attracting more attention. Clinical outcomes for patients with esophageal cancer in a real-world setting might be different from data in randomized controlled trials. This study aime...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2020-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0231456 |
| _version_ | 1818677917587079168 |
|---|---|
| author | Hye-Kyung Jung Chung Hyun Tae Hye-Ah Lee Hyuk Lee Kee Don Choi Jun Chul Park Joong Goo Kwon Yoon Jin Choi Su Jin Hong Jaekyu Sung Woo Chul Chung Ki Bae Kim Seung Young Kim Kyung Ho Song Kyung Sik Park Seong Woo Jeon Byung-Wook Kim Han Seung Ryu Ok-Jae Lee Gwang Ho Baik Yong Sung Kim Hwoon-Yong Jung Korean College of Helicobacter and Upper Gastrointestinal Research |
| author_facet | Hye-Kyung Jung Chung Hyun Tae Hye-Ah Lee Hyuk Lee Kee Don Choi Jun Chul Park Joong Goo Kwon Yoon Jin Choi Su Jin Hong Jaekyu Sung Woo Chul Chung Ki Bae Kim Seung Young Kim Kyung Ho Song Kyung Sik Park Seong Woo Jeon Byung-Wook Kim Han Seung Ryu Ok-Jae Lee Gwang Ho Baik Yong Sung Kim Hwoon-Yong Jung Korean College of Helicobacter and Upper Gastrointestinal Research |
| author_sort | Hye-Kyung Jung |
| collection | DOAJ |
| description | Using data from the real world to solve clinical questions that cannot be answered using data from clinical trials is attracting more attention. Clinical outcomes for patients with esophageal cancer in a real-world setting might be different from data in randomized controlled trials. This study aimed to provide real world data on treatment and prognosis in Korean patients with esophageal cancer. This retrospective cancer cohort included newly diagnosed cases of esophageal cancer at 19 tertiary hospitals between January 1, 2005 and December 31, 2017. Cancer staging was defined according to the 7th edition of the American Joint Committee on Cancer criteria. We identified 6,354 patients with newly diagnosed esophageal cancer (mean age: 64.9 ± 9.0 years, 96.9% squamous cell carcinoma). The proportion of early esophageal cancer increased from 24.7% in 2005 to 37.2% in 2015 (p<0.001). Among all cases, surgery alone was 31.3%, followed by definitive concurrent chemoradiotherapy (CCRT) (27.0%), neoadjuvant therapy (12.4%), adjuvant therapy (11.1%), and endoscopic resection (5.8%). The 5-year overall survival rate was 45.7 ± 0.7%. Endoscopic resection provided similar median survival relative to surgery for stage Ia cases. Among stage II-III cases, definitive CCRT was associated with poorer survival than neoadjuvant or adjuvant therapy, although there was no survival difference between neo-adjuvant and adjuvant therapy. Early esophageal cancer is gradually becoming more common and endoscopic resection provided similar long-term survival relative to surgery. Surgery with combined therapy provided better survival in locally advanced esophageal cancer, relative to definitive CCRT. |
| first_indexed | 2024-12-17T09:06:59Z |
| format | Article |
| id | doaj.art-fd858b88356a40dabc3e6362fd7d1d05 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T09:06:59Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-fd858b88356a40dabc3e6362fd7d1d052022-12-21T21:55:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01154e023145610.1371/journal.pone.0231456Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients.Hye-Kyung JungChung Hyun TaeHye-Ah LeeHyuk LeeKee Don ChoiJun Chul ParkJoong Goo KwonYoon Jin ChoiSu Jin HongJaekyu SungWoo Chul ChungKi Bae KimSeung Young KimKyung Ho SongKyung Sik ParkSeong Woo JeonByung-Wook KimHan Seung RyuOk-Jae LeeGwang Ho BaikYong Sung KimHwoon-Yong JungKorean College of Helicobacter and Upper Gastrointestinal ResearchUsing data from the real world to solve clinical questions that cannot be answered using data from clinical trials is attracting more attention. Clinical outcomes for patients with esophageal cancer in a real-world setting might be different from data in randomized controlled trials. This study aimed to provide real world data on treatment and prognosis in Korean patients with esophageal cancer. This retrospective cancer cohort included newly diagnosed cases of esophageal cancer at 19 tertiary hospitals between January 1, 2005 and December 31, 2017. Cancer staging was defined according to the 7th edition of the American Joint Committee on Cancer criteria. We identified 6,354 patients with newly diagnosed esophageal cancer (mean age: 64.9 ± 9.0 years, 96.9% squamous cell carcinoma). The proportion of early esophageal cancer increased from 24.7% in 2005 to 37.2% in 2015 (p<0.001). Among all cases, surgery alone was 31.3%, followed by definitive concurrent chemoradiotherapy (CCRT) (27.0%), neoadjuvant therapy (12.4%), adjuvant therapy (11.1%), and endoscopic resection (5.8%). The 5-year overall survival rate was 45.7 ± 0.7%. Endoscopic resection provided similar median survival relative to surgery for stage Ia cases. Among stage II-III cases, definitive CCRT was associated with poorer survival than neoadjuvant or adjuvant therapy, although there was no survival difference between neo-adjuvant and adjuvant therapy. Early esophageal cancer is gradually becoming more common and endoscopic resection provided similar long-term survival relative to surgery. Surgery with combined therapy provided better survival in locally advanced esophageal cancer, relative to definitive CCRT.https://doi.org/10.1371/journal.pone.0231456 |
| spellingShingle | Hye-Kyung Jung Chung Hyun Tae Hye-Ah Lee Hyuk Lee Kee Don Choi Jun Chul Park Joong Goo Kwon Yoon Jin Choi Su Jin Hong Jaekyu Sung Woo Chul Chung Ki Bae Kim Seung Young Kim Kyung Ho Song Kyung Sik Park Seong Woo Jeon Byung-Wook Kim Han Seung Ryu Ok-Jae Lee Gwang Ho Baik Yong Sung Kim Hwoon-Yong Jung Korean College of Helicobacter and Upper Gastrointestinal Research Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients. PLoS ONE |
| title | Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients. |
| title_full | Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients. |
| title_fullStr | Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients. |
| title_full_unstemmed | Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients. |
| title_short | Treatment pattern and overall survival in esophageal cancer during a 13-year period: A nationwide cohort study of 6,354 Korean patients. |
| title_sort | treatment pattern and overall survival in esophageal cancer during a 13 year period a nationwide cohort study of 6 354 korean patients |
| url | https://doi.org/10.1371/journal.pone.0231456 |
| work_keys_str_mv | AT hyekyungjung treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT chunghyuntae treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT hyeahlee treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT hyuklee treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT keedonchoi treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT junchulpark treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT joonggookwon treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT yoonjinchoi treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT sujinhong treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT jaekyusung treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT woochulchung treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT kibaekim treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT seungyoungkim treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT kyunghosong treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT kyungsikpark treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT seongwoojeon treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT byungwookkim treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT hanseungryu treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT okjaelee treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT gwanghobaik treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT yongsungkim treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT hwoonyongjung treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients AT koreancollegeofhelicobacteranduppergastrointestinalresearch treatmentpatternandoverallsurvivalinesophagealcancerduringa13yearperiodanationwidecohortstudyof6354koreanpatients |