Ege Ünı̇ versı̇tesı̇ hastanesı̇ veri tabanındaki özofagus kanserlerinin epidemiyolojisi ve sağkalım özellikleri
Öz
Amaç: Bu çalışmada özofagus kanserlerinin (ÖK) epidemiyolojik ve genel sağkalım (GSK) özelliklerinin
araştırılması amaçlanmıştır.
Gereç Yöntem: Ege Üniversitesi Kanserle Savaş Uygulama ve Araştırma Merkezinin 1992-2017 yılları
arasındaki verileri retrospektif olarak taranmıştır. CANREG-4 bilgisayar programına kayıtlı kanser verileri,
Dünya Sağlık Örgütü ve Surveillance, Epidemiology, and End Results sisteminde gruplanmış ve
analizleri yapılmıştır. İstatistik analizlerde ki-kare testi, General Linear Model ve Kaplan Meier sağkalım
analizleri uygulanmıştır.
Bulgular: Toplam 117.139 kanserden 19.542’u gastrointestinal sistem (GİS) kanserleridir. GİS
kanserlerinin 1.009’u (%5,2) ÖK olup, GİS kanserleri içinde 6. sıklıktadır. ÖK’de 25 yılda doğrusal artış
izlenmemiştir. Medyan yaş 60 (15-90) yıldır. Olguların 573’ü (%56,8) erkektir. ÖK, erkeklerde en sık 60-
69 yaşlarda (%31), kadınlarda 50-59 yaşlarda (%25,2) görülmektedir. En sık yerleşim torasik
özofagustur (%79) ve yerleşim yeri açısından cinsiyetler arasında fark saptanmamıştır (p=0,33).
Skuamöz hücreli karsinom (SHK) en sık rastlanan histolojik tiptir (%64,2). Servikal ve torasik özofagusda
SHK, abdominal özofagusta adenokarsinom daha fazladır. Vakaların yaklaşık yarısı tanıyı lokal ileri
evrede almıştır. Medyan sağkalım 12 aydır. Bir, 5 ve 10-yıllık GSK oranları, sırasıyla %50,1, %17,7 ve
%12’dir. Erkeklerde 5-yıllık GSK oranı %11,2 ve kadınlarda %25,8’dir, cinsiyetler arası fark anlamlıdır
(p<0,0001). SHK’da 5-yıllık GSK oranı %20, adenokanserlerde %11,5 saptanmıştır. Evrelere göre 5-
yıllık GSK oranı; lokalize evrede %35,1, lokal ileri evrede %15,1 ve metastatik evrede %7,8 saptanmıştır.
Sonuç: ÖK, daha çok erkeklerde, torasik segmentte (orta özofagus) ve SHK histolojisinde saptanmıştır.
Cinsiyet ve evre prognozda önemlidir.
Anahtar Kelimeler
Kaynakça
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394-424.
- Blot W, McLaughlin J, and Fraumeni, J. Esophageal cancer. In: D. Schottenfeld, J. Fraumeni (Eds.). Cancer epidemiology and prevention. 3rd ed. New York: Oxford University Press; 2006: 697–706.
- M. Arnold, N. Pandeya, G. Byrnes, A.G. Renehan, G.A. Stevens, M. Ezzati, et al. Global burden of cancer attributable to high body-mass index in 2012: a population-based study, Lancet Oncol 2015;16(1):36–46.
- Pennathur A, Gibson MK, Jobe BA, Luketich JD. Oesophageal carcinoma. Lancet. 2013 Feb 2; 381(9864):400-12.
- Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á. Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries. World J Gastroenterol. 2015;21(26):7933–43.
- Zhang HZ, Jin GF, Shen HB. Epidemiologic differences in esophageal cancer between Asian and Western populations. Chin J Cancer. 2012 Jun; 31(6):281-6.
- TC Sağlık Bakanlığı Kanser İstatistikleri [homepage on the internet]. 2015 Kanser İstatistikleri [cited 15 July 2020]. available from www.kanser.gov.tr.
- Blot WJ, Tarone RE. Esophageal cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D (eds). Cancer Epidemiology and Prevention. 4th ed. New York: Oxford University Press; 2018:579-92.
- McCormack VA, Menya D, Munishi MO, et al. Informing etiologic research priorities for squamous cell esophageal cancer in Africa: a review of setting-specific exposures to known and putative risk factors. Int J Cancer. 2017;140(2):259-71.
- De Martel C, Parsonnet J. Stomach cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D (eds). Cancer Epidemiology and Prevention. 4th ed. New York: Oxford University Press; 2018:593‐610.
- Bayrakci B, Kasap E, Kitapcioglu G, Bor S. Low prevalence of erosive esophagitis and Barrett esophagus in a tertiary referral center in Turkey. Turk J Gastroenterol 2008;19(3):145-51.
- H. Nordenstedt, H. El-Serag, The influence of age, sex, and race on the incidence of esophageal cancer in the United States (1992–2006), Scand. J. Gastroenterol. 2011;46(5):597–602.
- Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/archive/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.
- Micheli A, Ciampichini R, Overaigner W, Ciccolallo L, de Vries E, Izarzugaza I, et al. The advantage of women in cancer survival: an analysis of EUROCARE-4 data. Eur J Cancer 2009;45(6):1017–27.
- Mariette C, Finzi L, Piessen G, et al. et al. Esophageal carcinoma: prognostic differences between squamous cell carcinoma and adenocarcinoma. World J Surg. 2005;29(1):39–45.
Epidemiology and survival characteristics of patients with esophageal cancer in Ege Unıversity database
Öz
Aim: The study aimed to investigate epidemiologic and overall survival (OS) characteristics of
esophageal cancers (EC).
Materials and Methods: Data of Ege University Cancer Control and Research Center were screened
between 1992-2017 retrospectively. Data recorded in the computer program CAN REG-4 were
grouped and analyzed in the World Health Organisation and Surveillance, Epidemiology, and End
Results systems. Chi-square, Kaplan Meier, and General Linear Model tests were used for statistical
analysis.
Results: Of the total 117,139 cancers, 19,542 are gastrointestinal system (GIS) cancers. 1,009 (5.2%)
of GIS cancers are EC and are 6th. There has not been any statistically significant increase in EC
during the 25 years. The median age was 60 (15-90) years. A total of 573 (56.8%) of patients were
male. EC was most commonly seen in men aged 60-69 (31%), in women aged 50-59 (25.2%) years.
The most common localization was thoracic esophagus (79%). There wasn’t any statistically
significant difference between gender according to localization (p=0.33). Squamous cell carcinoma
(SCC) was the most common histological type (64.2%). SCC was more common in cervical and
thoracic, adenocarcinoma was more common in abdominal esophagus. Half of the patients were
diagnosed at a locally advanced stage. Median survival was 12 months. The 1-, 5-, and 10-year OS
rates were 50.1%, 17.7%, and 12% respectively. The 5-year OS was 11.2% for men and 25.8% for
women, the difference was statistically significant (p<0.0001). The 5-year OS of SCC was 20% and
11.5% in adenocarcinoma. The 5-year survival was 35.1% in local, 15.1% in locally advanced and
7.8% in metastatic stages, respectively.
Conclusion: EC was more common in men; the most common localization was thoracic segment.
SCC was the most common histological type. Gender and stages are the most important parameters
in prognosis.
Anahtar Kelimeler
Kaynakça
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394-424.
- Blot W, McLaughlin J, and Fraumeni, J. Esophageal cancer. In: D. Schottenfeld, J. Fraumeni (Eds.). Cancer epidemiology and prevention. 3rd ed. New York: Oxford University Press; 2006: 697–706.
- M. Arnold, N. Pandeya, G. Byrnes, A.G. Renehan, G.A. Stevens, M. Ezzati, et al. Global burden of cancer attributable to high body-mass index in 2012: a population-based study, Lancet Oncol 2015;16(1):36–46.
- Pennathur A, Gibson MK, Jobe BA, Luketich JD. Oesophageal carcinoma. Lancet. 2013 Feb 2; 381(9864):400-12.
- Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á. Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries. World J Gastroenterol. 2015;21(26):7933–43.
- Zhang HZ, Jin GF, Shen HB. Epidemiologic differences in esophageal cancer between Asian and Western populations. Chin J Cancer. 2012 Jun; 31(6):281-6.
- TC Sağlık Bakanlığı Kanser İstatistikleri [homepage on the internet]. 2015 Kanser İstatistikleri [cited 15 July 2020]. available from www.kanser.gov.tr.
- Blot WJ, Tarone RE. Esophageal cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D (eds). Cancer Epidemiology and Prevention. 4th ed. New York: Oxford University Press; 2018:579-92.
- McCormack VA, Menya D, Munishi MO, et al. Informing etiologic research priorities for squamous cell esophageal cancer in Africa: a review of setting-specific exposures to known and putative risk factors. Int J Cancer. 2017;140(2):259-71.
- De Martel C, Parsonnet J. Stomach cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D (eds). Cancer Epidemiology and Prevention. 4th ed. New York: Oxford University Press; 2018:593‐610.
- Bayrakci B, Kasap E, Kitapcioglu G, Bor S. Low prevalence of erosive esophagitis and Barrett esophagus in a tertiary referral center in Turkey. Turk J Gastroenterol 2008;19(3):145-51.
- H. Nordenstedt, H. El-Serag, The influence of age, sex, and race on the incidence of esophageal cancer in the United States (1992–2006), Scand. J. Gastroenterol. 2011;46(5):597–602.
- Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/archive/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.
- Micheli A, Ciampichini R, Overaigner W, Ciccolallo L, de Vries E, Izarzugaza I, et al. The advantage of women in cancer survival: an analysis of EUROCARE-4 data. Eur J Cancer 2009;45(6):1017–27.
- Mariette C, Finzi L, Piessen G, et al. et al. Esophageal carcinoma: prognostic differences between squamous cell carcinoma and adenocarcinoma. World J Surg. 2005;29(1):39–45.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 26 Ekim 2020 |
| Gönderilme Tarihi | 28 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2020 |
Kaynak Göster