Annals of Surgical Oncology

, Volume 19, Issue 5, pp 1685–1691

Changes in Age, Stage Distribution, and Survival of Patients with Esophageal Adenocarcinoma over Three Decades in the United States

  • Putao Cen
  • Farzaneh Banki
  • Lee Cheng
  • Kamal Khalil
  • Xianglin L. Du
  • Michael Fallon
  • Robert J. Amato
  • Larry R. Kaiser
Thoracic Oncology

DOI: 10.1245/s10434-011-2141-1

Cite this article as:
Cen, P., Banki, F., Cheng, L. et al. Ann Surg Oncol (2012) 19: 1685. doi:10.1245/s10434-011-2141-1

Abstract

Background

Our aim was to evaluate the changes in age, stage distribution, and overall survival (OS) of patients with esophageal adenocarcinoma (EAC) over time.

Methods

Patients from the Surveillance, Epidemiology, and End Results (SEER) database aged ≥20 with invasive EAC, diagnosed from 1973–2003 were reviewed. Survival follow-up ended in 2006.

Results

There were 11,620 patients; 6580 (57%) aged ≥65. The stage distribution was 22%, 35%, and 43% for localized, regional, and distant metastasis for patients aged <65, and 33%, 33%, and 34% for patients aged ≥65. The number of patients ≥65 years with localized stage increased over time. Three-year OS for localized, regional, and distant disease increased from 19%, 10%, and 1% in 1973–1976, to 34%, 13%, and 2% in 1987–1991, and to 45%, 25%, and 4% in 2002–2003 (P < 0.001). A sub-analysis of 5475 patients from 1988–2002 showed better survival for patients with esophagectomy for all stages. Three-year OS for 2074 patients with esophagectomy improved every 5 years from 1988–2002 (39%, 43% to 54%, P < 0.001). Stratified by stage, year and esophagectomy status, patients aged <65 had better survival compared to patients aged ≥65 (P < 0.001).

Conclusions

There has been a substantial improvement in overall survival among patients with invasive EAC over the last 3 decades. Patients receiving esophagectomy had longer survival. Survival with esophagectomy improved in each time period. Although younger EAC patients were diagnosed at more advanced stages over time, they had better survival.

Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Putao Cen
    • 1
  • Farzaneh Banki
    • 2
  • Lee Cheng
    • 3
  • Kamal Khalil
    • 2
  • Xianglin L. Du
    • 4
  • Michael Fallon
    • 5
  • Robert J. Amato
    • 1
  • Larry R. Kaiser
    • 2
  1. 1.Division of Oncology, Department of Internal MedicineThe University of Texas Medical School at HoustonHoustonUSA
  2. 2.Department of Cardiothoracic and Vascular SurgeryThe University of Texas Medical School at HoustonHoustonUSA
  3. 3.Department of Biostatistics, School of Public HealthUniversity of Texas Health Science Center at HoustonHoustonUSA
  4. 4.Department of Epidemiology, School of Public HealthUniversity of Texas Health Science Center at HoustonHoustonUSA
  5. 5.Division of Gastroenterology, Hepatology and Nutrition, Department of Internal MedicineThe University of Texas Medical School at HoustonHoustonUSA

Personalised recommendations