Improvement in survival for patients with synchronous metastatic esophageal cancer in the south of the Netherlands from 1994 to 2013

N. Bernards, N.H. Mohammed, G.J. Creemers, T. Rozema, J.A. Roukema, G.A.P. Nieuwenhuijzen, M. van Laarhoven, M.J.C. van der Sangen, V.E.P.P. Lemmens

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: 
We assessed the use of external beam radiotherapy, brachytherapy chemoradiotherapy and chemotherapy in patients with metastatic esophageal cancer and evaluated the effect on overall survival.
Methods: 
We included all patients diagnosed with synchronous metastatic esophageal cancer in the south of the Netherlands between 1 January 1994 and 31 December 2013. Proportions of patients treated with external beam radiotherapy, brachytherapy, chemoradiotherapy and chemotherapy were described with respect to the period of diagnosis, patient and tumor characteristics. Independent risk factors for death were discriminated.
Results: 
A total of 1020 patients were included, 61.5% of these patients received palliative treatment with external beam radiotherapy, chemoradiotherapy, brachytherapy and/or chemotherapy. The use of external beam radiotherapy decreased from 44.5% in 1994 to 22.2% in 2013 (p = 0.0001), whereas the use of chemoradiotherapy increased from 2.9% in 1994 to 19.1% in 2013 (p < 0.0001). The prescription of systemic chemotherapy as single modality increased from 13.9% to 30.5% (p < 0.0001). The use of brachytherapy decreased from 20.9% in 1994 to 7.4% in 2013 (p = 0.0013). The odds of receiving external beam radiotherapy, brachytherapy, chemoradiotherapy and chemotherapy were influenced by different tumor and patient characteristics, such as age, gender, histologic subtype and number of metastatic sites. The median overall survival in patients with metastatic esophageal cancer significantly improved over time from 18 weeks (one-year survival rate 14.4%) in 1994–1998 to 25 weeks (one-year survival rate 22.4%) in 2009–2013. Patients treated with chemoradiotherapy had the most favorable prognosis, followed by patients treated with chemotherapy as a single modality.
Conclusion: 
The median overall survival of patients diagnosed with metastatic esophageal cancer improved from 18 weeks in 1994–1998 to 25 weeks in 2009–2013. Although this increase could be attributed to stage migration, our population-based study suggests that major changes in treatment strategies and appropriate patient selection might have played a role as well.
Original languageEnglish
Pages (from-to)1161-1167
JournalActa Oncologica
Volume55
Issue number9-10
DOIs
Publication statusPublished - 2016

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Esophageal Neoplasms
Netherlands
Survival Rate
Palliative Care
Patient Selection
Neoplasms

Cite this

Bernards, N., Mohammed, N. H., Creemers, G. J., Rozema, T., Roukema, J. A., Nieuwenhuijzen, G. A. P., ... Lemmens, V. E. P. P. (2016). Improvement in survival for patients with synchronous metastatic esophageal cancer in the south of the Netherlands from 1994 to 2013. Acta Oncologica, 55(9-10), 1161-1167. https://doi.org/10.1080/0284186X.2016.1176249
Bernards, N. ; Mohammed, N.H. ; Creemers, G.J. ; Rozema, T. ; Roukema, J.A. ; Nieuwenhuijzen, G.A.P. ; van Laarhoven, M. ; van der Sangen, M.J.C. ; Lemmens, V.E.P.P. / Improvement in survival for patients with synchronous metastatic esophageal cancer in the south of the Netherlands from 1994 to 2013. In: Acta Oncologica. 2016 ; Vol. 55, No. 9-10. pp. 1161-1167.
@article{b561ee98f0f0402d808cc43d912afd68,
title = "Improvement in survival for patients with synchronous metastatic esophageal cancer in the south of the Netherlands from 1994 to 2013",
abstract = "Background: We assessed the use of external beam radiotherapy, brachytherapy chemoradiotherapy and chemotherapy in patients with metastatic esophageal cancer and evaluated the effect on overall survival.Methods: We included all patients diagnosed with synchronous metastatic esophageal cancer in the south of the Netherlands between 1 January 1994 and 31 December 2013. Proportions of patients treated with external beam radiotherapy, brachytherapy, chemoradiotherapy and chemotherapy were described with respect to the period of diagnosis, patient and tumor characteristics. Independent risk factors for death were discriminated.Results: A total of 1020 patients were included, 61.5{\%} of these patients received palliative treatment with external beam radiotherapy, chemoradiotherapy, brachytherapy and/or chemotherapy. The use of external beam radiotherapy decreased from 44.5{\%} in 1994 to 22.2{\%} in 2013 (p = 0.0001), whereas the use of chemoradiotherapy increased from 2.9{\%} in 1994 to 19.1{\%} in 2013 (p < 0.0001). The prescription of systemic chemotherapy as single modality increased from 13.9{\%} to 30.5{\%} (p < 0.0001). The use of brachytherapy decreased from 20.9{\%} in 1994 to 7.4{\%} in 2013 (p = 0.0013). The odds of receiving external beam radiotherapy, brachytherapy, chemoradiotherapy and chemotherapy were influenced by different tumor and patient characteristics, such as age, gender, histologic subtype and number of metastatic sites. The median overall survival in patients with metastatic esophageal cancer significantly improved over time from 18 weeks (one-year survival rate 14.4{\%}) in 1994–1998 to 25 weeks (one-year survival rate 22.4{\%}) in 2009–2013. Patients treated with chemoradiotherapy had the most favorable prognosis, followed by patients treated with chemotherapy as a single modality.Conclusion: The median overall survival of patients diagnosed with metastatic esophageal cancer improved from 18 weeks in 1994–1998 to 25 weeks in 2009–2013. Although this increase could be attributed to stage migration, our population-based study suggests that major changes in treatment strategies and appropriate patient selection might have played a role as well.",
author = "N. Bernards and N.H. Mohammed and G.J. Creemers and T. Rozema and J.A. Roukema and G.A.P. Nieuwenhuijzen and {van Laarhoven}, M. and {van der Sangen}, M.J.C. and V.E.P.P. Lemmens",
note = "Geen affiliatie met TiU. Affiliatie Roukema: Department of Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands",
year = "2016",
doi = "10.1080/0284186X.2016.1176249",
language = "English",
volume = "55",
pages = "1161--1167",
journal = "Acta Oncologica",
issn = "0284-186X",
publisher = "TAYLOR & FRANCIS LTD",
number = "9-10",

}

Bernards, N, Mohammed, NH, Creemers, GJ, Rozema, T, Roukema, JA, Nieuwenhuijzen, GAP, van Laarhoven, M, van der Sangen, MJC & Lemmens, VEPP 2016, 'Improvement in survival for patients with synchronous metastatic esophageal cancer in the south of the Netherlands from 1994 to 2013' Acta Oncologica, vol. 55, no. 9-10, pp. 1161-1167. https://doi.org/10.1080/0284186X.2016.1176249

Improvement in survival for patients with synchronous metastatic esophageal cancer in the south of the Netherlands from 1994 to 2013. / Bernards, N.; Mohammed, N.H.; Creemers, G.J.; Rozema, T.; Roukema, J.A.; Nieuwenhuijzen, G.A.P.; van Laarhoven, M.; van der Sangen, M.J.C.; Lemmens, V.E.P.P.

In: Acta Oncologica, Vol. 55, No. 9-10, 2016, p. 1161-1167.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Improvement in survival for patients with synchronous metastatic esophageal cancer in the south of the Netherlands from 1994 to 2013

AU - Bernards, N.

AU - Mohammed, N.H.

AU - Creemers, G.J.

AU - Rozema, T.

AU - Roukema, J.A.

AU - Nieuwenhuijzen, G.A.P.

AU - van Laarhoven, M.

AU - van der Sangen, M.J.C.

AU - Lemmens, V.E.P.P.

N1 - Geen affiliatie met TiU. Affiliatie Roukema: Department of Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands

PY - 2016

Y1 - 2016

N2 - Background: We assessed the use of external beam radiotherapy, brachytherapy chemoradiotherapy and chemotherapy in patients with metastatic esophageal cancer and evaluated the effect on overall survival.Methods: We included all patients diagnosed with synchronous metastatic esophageal cancer in the south of the Netherlands between 1 January 1994 and 31 December 2013. Proportions of patients treated with external beam radiotherapy, brachytherapy, chemoradiotherapy and chemotherapy were described with respect to the period of diagnosis, patient and tumor characteristics. Independent risk factors for death were discriminated.Results: A total of 1020 patients were included, 61.5% of these patients received palliative treatment with external beam radiotherapy, chemoradiotherapy, brachytherapy and/or chemotherapy. The use of external beam radiotherapy decreased from 44.5% in 1994 to 22.2% in 2013 (p = 0.0001), whereas the use of chemoradiotherapy increased from 2.9% in 1994 to 19.1% in 2013 (p < 0.0001). The prescription of systemic chemotherapy as single modality increased from 13.9% to 30.5% (p < 0.0001). The use of brachytherapy decreased from 20.9% in 1994 to 7.4% in 2013 (p = 0.0013). The odds of receiving external beam radiotherapy, brachytherapy, chemoradiotherapy and chemotherapy were influenced by different tumor and patient characteristics, such as age, gender, histologic subtype and number of metastatic sites. The median overall survival in patients with metastatic esophageal cancer significantly improved over time from 18 weeks (one-year survival rate 14.4%) in 1994–1998 to 25 weeks (one-year survival rate 22.4%) in 2009–2013. Patients treated with chemoradiotherapy had the most favorable prognosis, followed by patients treated with chemotherapy as a single modality.Conclusion: The median overall survival of patients diagnosed with metastatic esophageal cancer improved from 18 weeks in 1994–1998 to 25 weeks in 2009–2013. Although this increase could be attributed to stage migration, our population-based study suggests that major changes in treatment strategies and appropriate patient selection might have played a role as well.

AB - Background: We assessed the use of external beam radiotherapy, brachytherapy chemoradiotherapy and chemotherapy in patients with metastatic esophageal cancer and evaluated the effect on overall survival.Methods: We included all patients diagnosed with synchronous metastatic esophageal cancer in the south of the Netherlands between 1 January 1994 and 31 December 2013. Proportions of patients treated with external beam radiotherapy, brachytherapy, chemoradiotherapy and chemotherapy were described with respect to the period of diagnosis, patient and tumor characteristics. Independent risk factors for death were discriminated.Results: A total of 1020 patients were included, 61.5% of these patients received palliative treatment with external beam radiotherapy, chemoradiotherapy, brachytherapy and/or chemotherapy. The use of external beam radiotherapy decreased from 44.5% in 1994 to 22.2% in 2013 (p = 0.0001), whereas the use of chemoradiotherapy increased from 2.9% in 1994 to 19.1% in 2013 (p < 0.0001). The prescription of systemic chemotherapy as single modality increased from 13.9% to 30.5% (p < 0.0001). The use of brachytherapy decreased from 20.9% in 1994 to 7.4% in 2013 (p = 0.0013). The odds of receiving external beam radiotherapy, brachytherapy, chemoradiotherapy and chemotherapy were influenced by different tumor and patient characteristics, such as age, gender, histologic subtype and number of metastatic sites. The median overall survival in patients with metastatic esophageal cancer significantly improved over time from 18 weeks (one-year survival rate 14.4%) in 1994–1998 to 25 weeks (one-year survival rate 22.4%) in 2009–2013. Patients treated with chemoradiotherapy had the most favorable prognosis, followed by patients treated with chemotherapy as a single modality.Conclusion: The median overall survival of patients diagnosed with metastatic esophageal cancer improved from 18 weeks in 1994–1998 to 25 weeks in 2009–2013. Although this increase could be attributed to stage migration, our population-based study suggests that major changes in treatment strategies and appropriate patient selection might have played a role as well.

U2 - 10.1080/0284186X.2016.1176249

DO - 10.1080/0284186X.2016.1176249

M3 - Article

VL - 55

SP - 1161

EP - 1167

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

IS - 9-10

ER -