美国人口中食管腺癌的发病率、治疗方式和预后趋势。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2024-10-03 DOI:10.1016/j.canep.2024.102683

Zhuoyang Yu , Tong Chen , Haoyu Peng , Anyuan Li , Yutong Wei , Shiyu Xiao

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引用次数: 0

摘要

背景：食管腺癌（EAC）是西方人群中食管癌的主要亚型。然而，目前还缺乏对食管腺癌的流行病学、临床和预后特征的最新全面分析：这是一项基于人群的队列研究，使用的是监测、流行病学和最终结果（SEER）数据库。研究纳入了 1988 年至 2020 年期间确诊为 EAC 的患者。研究对发病趋势、临床特征、治疗模式和相对存活率进行了系统分析：结果：EAC的总体年龄标准化发病率从1988年的每10万人1.7例显著上升至2020年的每10万人3.6例。随着时间的推移，EAC的年龄组、性别和原发部位分布没有明显变化。不过，临床分期为 I 或 II 期的 EAC 比例从 35.1% 降至 27.9%。随着时间的推移，转移性EAC的姑息化疗比例从26.7%上升到41.3%，但联合疗法仍是非转移性EAC的主要治疗策略。尽管 5 年生存率不到 20%，但 1 年生存率却从 46.7% 增加到 53.7%。具体而言，接受手术治疗的非转移性 EAC 的 1 年生存率仅从 2004-2006 年的 80.2% 显著增加到 2019-2020 年的 94.7%。对于转移性 EAC，接受系统治疗者的 1 年生存率明显提高（从 2004-2006 年的 26.6% 提高到 2019-2020 年的 41.2%）。在多变量分析中，年龄较大、性别为男性、家庭收入较低、无伴侣生活、TNM分期较晚以及未接受癌症治疗与生存率较低显著相关：总之，这项针对美国 EAC 患者的人群研究表明，EAC 的发病率有所上升，转移性 EAC 的治疗方式有所转变，1 年生存率略有提高。未来应继续寻找更有效的监测和治疗策略。

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Trends in incidence, treatment modalities and prognosis of esophageal adenocarcinoma in the US population

Background

Esophageal adenocarcinoma (EAC) was the predominant subtype of esophageal cancer in the Western population. However, an updated and comprehensive analysis of epidemiologic, clinical, and prognostic characteristics of esophageal adenocarcinoma is lacking.

Materials and methods

This was a population-based cohort study using the Surveillance Epidemiology and End-Results (SEER) Database. Patients diagnosed with EAC between 1988 and 2020 were included. Incidence trends, clinical characteristics, treatment patterns, and relative survival were systematically analyzed.

Results

The overall age-standardized incidence rate of EAC significantly increased from 1.7 per 100000 persons in 1988 to 3.6 per 100000 persons in 2020. There were no significant changes in the distribution of age group, sex, and primary site of EAC over time. However, the proportion of EAC clinically staged as I or II decreased from 35.1 % to 27.9 %. Over time, palliative chemotherapy in metastatic EAC increased from 26.7 % to 41.3 %, combination therapy was still the main treatment strategy for nonmetastatic EAC. Despite the 5-year survival rate was less than 20 %, 1-year survival has experienced a moderate increase from 46.7 % to 53.7 %. Specifically, 1-year survival rate for nonmetastatic EAC undergoing surgery only experienced a significant increase from 80.2 % in 2004–2006 to 94.7 % in 2019–2020. For metastatic EAC, obvious improvement in 1-year survival rate was observed in those treated with systematic therapy (from 26.6 % in 2004–2006 to 41.2 % in 2019–2020). In the multivariable analysis, older age, male sex, lower household income, living without a partner, advanced TNM stage, and receiving no cancer treatment were significantly associated with poor survival.

Conclusion

In summary, this population-based study of EAC patients in the US showed an increase in incidence, a shift in treatment modalities for metastatic EAC, and moderately improved 1-year survival. The search for more effective surveillance and treatment strategies should be continued in the future.

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.