Experience with Oesophageal Cancer: A Ten-Year Single Centre Study Reflecting Daily Practice

Introduction. Studied patients with oesophageal cancer do not represent normal daily presentation. Aim. A retrospective study was done in all consecutive patients in order to describe presentation, treatment, and survival. Patients. All patients in a ten-year period were included. Patients were grouped in three groups. Group 1: no metastases and potentially curable, dead, or alive at time of evaluation. Group 2: patients presenting with metastases and treated with palliative chemotherapy, and group 3: patients with or without metastases but untreatable because of low Karnofsky index or important comorbidity rendering treatment not feasible. Results. One hundred thirty one evaluable patients were included. There was no difference in histological type of the tumour. Patients in group 3 were significantly older. Survival was not different between groups 2 and 3. Survival in group 1 was significantly longer ( ) compared with groups 2 and 3. Patients in group 1 received treatment with chemoradiation and surgery. Patients in groups 2 and 3 were more often treated with palliative chemotherapy and endoscopic stenting. Conclusion. The overall survival of oesophageal cancer in normal daily life is poor. Supportive care seems to be the best treatment option in patients with metastases or low Karnofsky index. Palliative chemotherapy does not add to overall survival. 1. Introduction Oesophageal cancer is diagnosed in about 400,000 patients each year worldwide, and its incidence is increasing. This makes it the ninth most common malignancy and sixth on the list of cancer mortality causes [1]. Studies on oesophageal cancer in the literature report on successful treatment: chemotherapy, radiotherapy, and surgery. Over the years the pattern of treatment options is changing. In the beginning of this century, surgery was the best option for reaching cure. The present standard therapy of potentially curable disease is the combination of neoadjuvant chemoradiation prior to surgical resection. Studies in the literature always include large numbers of treatable patients. However, this is not daily reality. In routine clinical daily practice, many patients present oesophageal cancer in a stage too advanced for curative therapy. Many patients do not show the initial presentation used as inclusion criterion in many clinical studies. Only a minority of the patients have potentially curable disease. It can be concluded that the studied population does not represent the normal patient population presenting with oesophageal cancer. For this reason, a retrospective longitudinal study