TY - JOUR
T1 - Conditional Survival of Patients Who Underwent Curative Resection for Esophageal Squamous Cell Carcinoma
AU - Shin, Dong Wook
AU - Kim, Hong Kwan
AU - Cho, Jongho
AU - Lee, Genehee
AU - Cho, Juhee
AU - Yoo, Jung Eun
AU - Shin, Sumin
AU - Choi, Yong Soo
AU - Shim, Young Mog
AU - Zo, Jae Ill
N1 - Funding Information:
This work was supported by an intramural research grant from the Samsung Medical Center (creative research program). The funding source played no role in study design, data collection and analysis, writing of the report, or decision to submit the report for publication.
Funding Information:
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2018R 1D 1A 1B 07050523) and the National R&D Program for Cancer Control, Ministry of Health & Welfare, Korea (1720180).
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Objective: To analyze conditional survival estimates of patients with esophageal cancer who underwent curative resection. Summary Background Data: Conditional survival reflects dynamic prognosis updated to the current status and is a more relevant indicator for current healthcare and life decisions. Methods: This study included 1883 patients who underwent complete resection for esophageal squamous cell carcinoma at a tertiary cancer center from 1994 to 2016. We calculated 5-year (5Y) conditional overall survival (COS), conditional recurrence-free survival (CRFS), and conditional relative survival (CRS) estimates from diagnosis to 5 years of survival. Results: The 5Y COS, CRFS, and CRS increased from 63.7%, 65.2%, and 70.2% at diagnosis to 75.8%, 91.9%, and 86.4 at 5 years after diagnosis, respectively. While there were large differences with different stages (stage I, II, III) at diagnosis (81.2%, 64.9%, and 37.3% for COS; 85.1, 65.1%, and 67.9% for CRFS; 89.2%, 72.1%, and 41.1% for CRS), the gap decreased with time; rates were similar after 5 years (77.1%, 75.7%, and 72.6% for COS; 91.7%, 90.6%, and 94.5% for CRFS, and 89.3%, 85.4%, and 78.3% in CRS, respectively). The 5Y COS, CRFS, and CRS were persistently lower in older patients even after 5 years. Conclusions: Conditional survival estimates generally increase over time, and the largest improvements were observed for patients with advanced stage. Availability of updated prognosis at various time points allows clinicians to better guide their patients. Our results also imply substantial residual risk of recurrence and sustained excess mortality compared to the general population even after 5 years.
AB - Objective: To analyze conditional survival estimates of patients with esophageal cancer who underwent curative resection. Summary Background Data: Conditional survival reflects dynamic prognosis updated to the current status and is a more relevant indicator for current healthcare and life decisions. Methods: This study included 1883 patients who underwent complete resection for esophageal squamous cell carcinoma at a tertiary cancer center from 1994 to 2016. We calculated 5-year (5Y) conditional overall survival (COS), conditional recurrence-free survival (CRFS), and conditional relative survival (CRS) estimates from diagnosis to 5 years of survival. Results: The 5Y COS, CRFS, and CRS increased from 63.7%, 65.2%, and 70.2% at diagnosis to 75.8%, 91.9%, and 86.4 at 5 years after diagnosis, respectively. While there were large differences with different stages (stage I, II, III) at diagnosis (81.2%, 64.9%, and 37.3% for COS; 85.1, 65.1%, and 67.9% for CRFS; 89.2%, 72.1%, and 41.1% for CRS), the gap decreased with time; rates were similar after 5 years (77.1%, 75.7%, and 72.6% for COS; 91.7%, 90.6%, and 94.5% for CRFS, and 89.3%, 85.4%, and 78.3% in CRS, respectively). The 5Y COS, CRFS, and CRS were persistently lower in older patients even after 5 years. Conclusions: Conditional survival estimates generally increase over time, and the largest improvements were observed for patients with advanced stage. Availability of updated prognosis at various time points allows clinicians to better guide their patients. Our results also imply substantial residual risk of recurrence and sustained excess mortality compared to the general population even after 5 years.
KW - Korea
KW - cancer survivor
KW - conditional survival
KW - esophageal cancer
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85134405999&partnerID=8YFLogxK
U2 - 10.1097/SLA.0000000000004473
DO - 10.1097/SLA.0000000000004473
M3 - Article
C2 - 33086317
AN - SCOPUS:85134405999
SN - 0003-4932
VL - 276
SP - E86-E92
JO - Annals of Surgery
JF - Annals of Surgery
IS - 2
ER -