Original CommunicationPopulation-based esophageal cancer survival after resection without neoadjuvant therapy: An update
Section snippets
Study design
The design of this nationwide Swedish, population-based, cohort study was presented in detail in our previous publication.6 In brief, patients with esophageal cancer were identified using the Swedish Cancer Register, which is 98% complete.9, 10 Data on surgical procedures, including type, date, and hospital, and data on comorbidities, were ascertained through the Swedish Patient Register by linkage with the patient's personal identity number.11 Two investigators (IR and KC) reviewed
Study subjects
Among 6,995 patients diagnosed with esophageal cancer in Sweden between 1987 and 2005, 1,481 (21%) underwent tumor resection. Of patients who underwent the operation, 422 (28%) were excluded because they had received neoadjuvant treatment, and 51 (3%) were excluded because data were missing. The remaining 1,008 patients made up the final esophageal cancer surgery cohort. The median age at operation was 67 years (range, 31–85), which did not differ between calendar periods of operation.
Discussion
The main finding of this population-based study is that long-term survival after esophageal cancer surgery has not improved since 2000; however, 30-day mortality after the operation has decreased during the same period.
Among the strengths of the current study are the population-based design that decreases selection bias, the completeness of follow-up, and the long observation time. Limitations include the lack of information regarding some surgical details, but the aim of the study was to
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Supported by The Swedish Research Council (SIMSAM) and the Swedish Cancer Society.