Trends in treatment and overall survival among patients with proximal esophageal cancer

Table 1 Patient and tumor charactistics by time period of diagnosis, n (%)

Charactistics	Total (n = 2783)	1989-1994 (n = 484)	1995-1999 (n = 499)	2000-2004 (n = 552)	2005-2009 (n = 583)	2010-2014 (n = 665)
Sex
Male	1562 (56)	259 (54)	263 (53)	308 (56)	344 (59)	388 (58)
Female	1221 (44)	225 (46)	236 (47)	244 (44)	239 (41)	277 (42)
Age (yr)
< 60	725 (26)	140 (29)	148 (30)	178 (32)	128 (22)	131 (20)
60-74	1304 (47)	194 (40)	219 (44)	223 (40)	301 (52)	367 (55)
≥ 75	754 (27)	150 (31)	132 (26)	151 (27)	154 (26)	167 (25)
Histology
SCC	2248 (81)	382 (79)	390(78)	440 (80)	480 (82)	556 (84)
Adenocarcino-ma	320 (11)	62 (13)	63 (13)	70 (13)	61 (10)	64 (10)
Other	215 (8)	40 (8)	46 (9)	42 (8)	42 (7)	45 (7)
Tumor location
CEC	648 (23)	138 (29)	138 (28)	154 (28)	126 (22)	92 (14)
UTEC	2135 (77)	346 (71)	361 (72)	398 (72)	457 (78)	573 (86)
cT classification
cT1	81 (3)	17 (4)	16 (3)	12 (2)	16 (3)	20 (3)
cT2	236 (8)	12 (2)	16 (3)	36 (7)	48 (8)	124 (19)
cT3	447 (16)	36 (7)	39 (8)	79 (14)	109 (19)	184 (28)
cT4	665 (24)	115 (24)	123 (25)	161 (29)	147 (25)	119 (18)
cTx	1354 (49)	304 (63)	305 (61)	264 (48)	263 (45)	218 (33)
cN classification
cN0	892 (32)	172 (36)	173 (35)	189 (34)	157 (27)	201 (30)
cN+	1193 (43)	119 (25)	158 (32)	208 (38)	313 (54)	395 (59)
cNx	698 (25)	193 (40)	168 (34)	155 (28)	113 (19)	69 (10)
cM classification
cM0	1752 (63)	311 (64)	314 (63)	316 (57)	344 (59)	467 (70)
cM1	589 (21)	79 (16)	88 (18)	96 (17)	135 (23)	191 (29)
cMx	442 (16)	94 (19)	97 (19)	140 (25)	104 (18)	7 (1)
TNM stage
1	64 (2)	14 (3)	14 (3)	9 (2)	14 (2)	13 (2)
2	565 (20)	80 (17)	72 (14)	100 (18)	125 (22)	188 (28)
3	763 (27)	102 (21)	126 (25)	173 (31)	174 (30)	188 (28)
4	589 (21)	79 (16)	88 (18)	96 (17)	135 (23)	191 (29)
Unknown	802 (29)	209 (43)	199 (40)	174 (32)	135 (23)	85 (13)

Percentages may not add up to 100 percent because of rounding. SCC: Squamous cell carcinoma; CEC: Cervical esophageal cancer; UTEC: Upper thoracic esophageal cancer.

Table 2 Univariable and multivariable hazard ratios for overall survival of patients diagnosed with non-metastatic proximal esophageal cancer (n = 2194)

Charactistics	n	Univariable analysis		Multivariable analysis		Multivariable analysis1
		HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value
Period
1989-1994	405	Ref.		Ref.		Ref.
1995-1999	411	0.92 (0.80-1.05)	0.21	0.91 (0.79-1.05)	0.18	0.85 (0.74-0.98)	0.03
2000-2004	456	0.92 (0.81-1.06)	0.24	0.97 (0.85-1.12)	0.71	0.94 (0.82-1.08)	0.39
2005-2009	448	0.73 (0.63-0.83)	< 0.001	0.77 (0.67-0.89)	< 0.001	0.88 (0.76-1.02)	0.09
2010-2014	474	0.59 (0.51-0.68)	< 0.001	0.72 (0.62-0.85)	< 0.001	0.94 (0.79-1.10)	0.43
Age
< 60 yr	562	Ref.		Ref.		Ref.
60-74 yr	1002	1.06 (0.95-1.18)	0.30	1.11 (0.99-1.23)	0.08	0.97 (0.86-1.08)	0.53
≥ 75 yr	630	1.50 (1.33-1.69)	< 0.001	1.51 (1.34-1.71)	< 0.001	1.00 (0.87-1.14)	0.95
Histology
SCC	1797	Ref.		Ref.		Ref.
AC	242	1.07 (0.93-1.23)	0.37	0.97 (0.84-1.12)	0.64	0.88 (0.76-1.02)	0.09
Other	155	1.47 (1.24-1.74)	< 0.001	1.22 (1.03-1.44)	0.02	1.11 (0.93-1.31)	0.25
Tumor location
UTEC	1672	Ref.		Ref.		Ref.
CEC	522	0.97 (0.88-1.08)	0.59	0.89 (0.80-0.98)	0.02	0.95 (0.86-1.06)	0.37
cT category
cT1-3	642	Ref.		Ref.		Ref.
cT4	506	2.03 (1.79-2.30)	< 0.001	1.93 (1.69-2.19)	< 0.001	1.62 (1.42-1.85)	< 0.001
cTx	1046	1.75 (1.57-1.94)	< 0.001	1.50 (1.33-1.69)	< 0.001	1.25 (1.11-1.41)	< 0.001
cN category
cN0	825	Ref.		Ref.		Ref.
cN+	811	1.29 (1.16-1.43)	< 0.001	1.44 (1.29-1.60)	< 0.001	1.35 (1.21-1.50)	< 0.001
cNx	558	2.06 (1.84-2.30)	< 0.001	1.78 (1.59-2.00)	< 0.001	1.37 (1.22-1.55)	< 0.001
Treatment
No localized treatment	538	Ref.				Ref.
Resection	183	0.19 (0.16-0.22)	< 0.001			0.22 (0.18-0.26)	< 0.001
Neoadjuvant and resection	126	0.15 (0.12-0.18)	< 0.001			0.17 (0.13-0.21)	< 0.001
Radio- and chemotherapy	480	0.17 (0.14-0.19)	< 0.001			0.19 (0.16-0.22)	< 0.001
Chemotherapy	67	0.38 (0.29-0.49)	< 0.001			0.39 (0.30-0.50)	< 0.001
Radiotherapy	800	0.38 (0.34-0.42)	< 0.001			0.40 (0.36-0.46)	< 0.001

¹Additionally adjusted for treatment category. SCC: Squamous cell carcinoma; AC: Adenocarcinoma; CEC: Cervical esophageal cancer; UTEC: Upper thoracic esophageal cancer; HR: Hazard ratio; CI: Confidence interval.