Surgery underused for esophagus cancer: study

NEW YORK (Reuters Health) - Surgery to remove the esophagus is not being used as often as it should be for some cases of early-stage cancer of the esophagus.

That's the conclusion of Dr. E. Carter Paulson and colleagues, from the Hospital of the University of Pennsylvania in Philadelphia, who assessed the treatment of 2,386 patients who were diagnosed with esophageal cancer from 1997 to 2002.

Overall, only 34 percent of patients had a surgical procedure for their cancer, the researchers found. Patients that did have surgery survived far longer than those that did not have surgery. Median survival was 620 days in surgery patients versus 381 days in medically-treated patients.

The survival rate at 2 years was 47 percent with surgery versus 32 percent without surgery. At 5 years, survival rates were 28 percent and 10 percent, respectively.

Roughly 37 percent of white patients with early cancer of the esophagus were treated surgically compared with just 19 percent of their non-white counterparts.

Living in a high poverty area reduced the likelihood of having surgery by 27 percent, the investigators found. Similarly, older age and having other illnesses in addition to esophagus cancer also cut the odds of having surgery.

In the medical journal Archives of Surgery, Paulson and colleagues point out that "refinements in operative technique and postoperative care have allowed resection to be performed with greater safety."

"It is imperative," they conclude, "that physicians diagnosing and treating patients with esophageal cancer be made aware of the positive progress in the surgical treatment of this disease."

SOURCE: Archives of Surgery, December 2008.