Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
Original Article
Clinical-Pathological Characteristics and Prognosis of a Cohort of Oesophageal Cancer Patients: a Competing Risks Survival Analysis
Elena Rodríguez-CamachoSalvador Pita-FernándezSonia Pértega-DíazBeatriz López-CalviñoTeresa Seoane-Pillado
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2015 Volume 25 Issue 3 Pages 231-238


Background: To determine the clinical course, follow-up strategies, and survival of oesophageal cancer patients using a competing risks survival analysis.
Methods: We conducted a retrospective and prospective follow-up study. The study included 180 patients with a pathological diagnosis of oesophageal cancer in A Coruña, Spain, between 2003 and 2008. The Kaplan-Meier methodology and competing risks survival analysis were used to calculate the specific survival rate. The study was approved by the Ethics Review Board (code 2011/372, CEIC Galicia).
Results: The specific survival rate at the first, third, and fifth years was 40.2%, 18.1%, and 12.4%, respectively. Using the Kaplan-Meier methodology, the survival rate was slightly higher after the third year of follow-up. In the multivariate analysis, poor prognosis factors were female sex (hazard ratio [HR] 1.94; 95% confidence interval [CI], 1.24–3.03), Charlson’s comorbidity index (HR 1.17; 95% CI, 1.02–1.33), and stage IV tumours (HR 1.70; 95% CI, 1.11–2.59). The probability of dying decreased with surgical and oncological treatment (chemotherapy and/or radiotherapy) (HR 0.23; 95% CI, 0.12–0.45). The number of hospital consultations per year during the follow-up period, from diagnosis to the appearance of a new event (local recurrences, newly appeared metastasis, and newly appeared neoplasias) did not affect the probability of survival (HR 1.03; 95% CI, 0.92–1.15).
Conclusions: The Kaplan-Meier methodology overestimates the survival rate in comparison to competing risks analysis. The variables associated with a poor prognosis are female sex, Charlson’s comorbidity score and extensive tumour invasion. Type of follow-up strategy employed after diagnosis does not affect the prognosis of the disease.

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© 2015 Elena Rodríguez-Camacho et al. This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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