TY - JOUR
T1 - Sex differences in treatment allocation and survival of potentially curable gastroesophageal cancer
T2 - A population-based study
AU - Kalff, Marianne C.
AU - Dijksterhuis, Willemieke P. M.
AU - Wagner, Anna D.
AU - Oertelt-Prigione, Sabine
AU - Verhoeven, Rob H. A.
AU - Lemmens, Valery E. P. P.
AU - van Laarhoven, Hanneke W. M.
AU - Gisbertz, Suzanne S.
AU - van Berge Henegouwen, Mark I.
N1 - Funding Information: The authors thank the registration team of the Netherlands Comprehensive Cancer Organization (IKNL) for the collection of data for the Netherlands Cancer Registry. Furthermore, we thank all participating hospitals in the Netherlands. Publisher Copyright: © 2023 The Author(s)
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background: Although curative treatment options are identical for male and female gastroesophageal cancer patients, access to care and survival may vary. This study aimed to compare treatment allocation and survival between male and female patients with potentially curable gastroesophageal cancer. Methods: Nationwide cohort study including all patients with potentially curable gastroesophageal squamous cell or adenocarcinoma diagnosed between 2006 and 2018 registered in the Netherlands Cancer Registry. The main outcome, treatment allocation, was compared between male and female patients with oesophageal adenocarcinoma (EAC), oesophageal squamous cell carcinoma (ESCC), and gastric adenocarcinoma (GAC). Additionally, 5-year relative survival with relative excess risk (RER), that is, adjusted for the normal life expectancy, was compared. Results: Among 27,496 patients (68.8% men), most were allocated to curative treatment (62.8%), although rates dropped to 45.6%>70 years. Curative treatment rates were comparable among younger male and female patients (≤70 years) with gastroesophageal adenocarcinoma, while older females with EAC were less frequently allocated to curative treatment than males (OR = 0.85, 95% confidence interval [CI] 0.73–0.99). For those allocated to curative treatment, relative survival was superior for female patients with EAC (RER = 0.88, 95% CI 0.80–0.96) and ESCC (RER = 0.82, 95% CI 0.75–0.91), and comparable for males and females with GAC (RER = 1.02, 95% CI 0.94–1.11). Conclusions: While curative treatment rates were comparable between younger male and female patients with gastroesophageal adenocarcinoma, treatment disparities were present between older patients. When treated, the survival of females with EAC and ESCC was superior to males. The treatment and survival gaps between male and female patients with gastroesophageal cancer warrant further exploration and could potentially improve treatment strategies and survival.
AB - Background: Although curative treatment options are identical for male and female gastroesophageal cancer patients, access to care and survival may vary. This study aimed to compare treatment allocation and survival between male and female patients with potentially curable gastroesophageal cancer. Methods: Nationwide cohort study including all patients with potentially curable gastroesophageal squamous cell or adenocarcinoma diagnosed between 2006 and 2018 registered in the Netherlands Cancer Registry. The main outcome, treatment allocation, was compared between male and female patients with oesophageal adenocarcinoma (EAC), oesophageal squamous cell carcinoma (ESCC), and gastric adenocarcinoma (GAC). Additionally, 5-year relative survival with relative excess risk (RER), that is, adjusted for the normal life expectancy, was compared. Results: Among 27,496 patients (68.8% men), most were allocated to curative treatment (62.8%), although rates dropped to 45.6%>70 years. Curative treatment rates were comparable among younger male and female patients (≤70 years) with gastroesophageal adenocarcinoma, while older females with EAC were less frequently allocated to curative treatment than males (OR = 0.85, 95% confidence interval [CI] 0.73–0.99). For those allocated to curative treatment, relative survival was superior for female patients with EAC (RER = 0.88, 95% CI 0.80–0.96) and ESCC (RER = 0.82, 95% CI 0.75–0.91), and comparable for males and females with GAC (RER = 1.02, 95% CI 0.94–1.11). Conclusions: While curative treatment rates were comparable between younger male and female patients with gastroesophageal adenocarcinoma, treatment disparities were present between older patients. When treated, the survival of females with EAC and ESCC was superior to males. The treatment and survival gaps between male and female patients with gastroesophageal cancer warrant further exploration and could potentially improve treatment strategies and survival.
KW - Gastric cancer
KW - Oesophageal cancer
KW - Sex
KW - Surgery
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85153949526&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ejca.2023.04.002
DO - https://doi.org/10.1016/j.ejca.2023.04.002
M3 - Article
C2 - 37146505
SN - 0959-8049
VL - 187
SP - 114
EP - 123
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -