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| 1 | Trends in treatment and overall survival among patients with proximal esophageal cancer显示文摘BACKGROUND The management of proximal esophageal cancer differs from that of tumors located in the mid and lower part of the esophagus due to the close vicinity of vital structures.Non-surgical treatment options like radiotherapy and definitive chemoradiation(CRT)have been implemented.The trends in(non-)surgical treatment and its impact on overall survival(OS)in patients with proximal esophageal cancer are unclear,related to its rare disease status.To optimize treatment strategies and counseling of patients with proximal esophageal cancer,it is therefore essential to gain more insight through real-life studies.AIM To establish trends in treatment and OS in patients with proximal esophageal cancer.METHODS In this population-based study,patients with proximal esophageal cancer diagnosed between 1989 and 2014 were identified in the Netherlands Cancer Registry.The proximal esophagus consists of the cervical esophagus and the upper thoracic section,extending to 24 cm from the incisors.Trends in radiotherapy,chemotherapy,and surgery,and OS were assessed.Analyses were stratified by presence of distant metastasis.Multivariable Cox proportional hazards regression analyses was performed to assess the effect of period of diagnosis on OS,adjusted for patient,tumor,and treatment characteristics.RESULTS In total,2783 patients were included.Over the study period,the use of radiotherapy,resection,and CRT in non-metastatic disease changed from 53%,23%,and 1%in 1989-1994 to 21%,9%,and 49%in 2010-2014,respectively.In metastatic disease,the use of chemotherapy and radiotherapy increased over time.Median OS of the total population increased from 7.3 mo[95%confidence interval(CI):6.4-8.1]in 1989-1994 to 9.5 mo(95%CI:8.1-10.8)in 2010-2014(logrank P<0.001).In non-metastatic disease,5-year OS rates improved from 5%(95%CI:3%-7%)in 1989-1994 to 13%(95%CI:9%-17%)in 2010-2014(logrank P<0.001).Multivariable regression analysis demonstrated a significant treatment effect over time on survival.In metastatic disease,median OS was 3.8 mo(95%CI:2.5-5.1)in 1989-1994,and 5.1 mo(95%CI:4.3-5.9)in 2010-2014(logrank P=0.26).CONCLUSION OS significantly improved in non-metastatic proximal esophageal cancer,likely to be associated with an increased use of CRT.Patterns in metastatic disease did not change significantly over time. | Judith de Vos-Geelen Sandra ME Geurts Liselot BJ Valkenburg-van Iersel Evelien JM de Jong Vivianne CG Tjan-Heijnen Margreet van Putten Valery EPP Lemmens Heike I Grabsch Nadia Haj Mohammad Frank JP Hoebers Chantal V Hoge Paul M Jeene Hanneke WM van Laarhoven Tom Rozema Marije Slingerland Grard AP Nieuwenhuijzen | 2019 | World Journal of Gastroenterology2019，25，47： | 2 |
| 2 | CT and MRI of hip arthroplasty显示文摘 | Cahir JG Toms AP Marshall TJ | 2007 | Clin Radiol2007，62，12： | 1 |
| 3 | The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography:a meta-analysis显示文摘 | Smith TO Hilton G Toms AP | 2011 | Eur Radiol2011，21，4： | 1 |
| 4 | Bone marrow oedema of the knee 显示文摘 | Fowkes LA Toms AP | 2010 | The [I I Knee2010，17，1： | 1 |
| 5 | Barker T (2005) Regional migratory osteoporosis: a review illustrated by five cases显示文摘 | TOMS AP MARSHALL1 TJ BECKER E | 2005 | Clin Radiol2005，60，4： | 1 |
| 6 | Diagnostic accuracy of ultrasound for rotator cuff tears in adults:A systematic review and metaanalysis显示文摘 | Smith TO Back T Toms AP | 2011 | Clinical Radiology2011，66，： | 1 |
| 7 | The impact of European research ethics legislation on UK radiology research activity:a bibliometric anal- ysis显示文摘 | Johnson CA Toms AP | 2009 | Clin Radiol2009，64，98： | 1 |
| 8 | Bone marrow oedema of the knee 显示文摘 | FOWKES LA TOMS AP | 2010 | The Knee2010，17，1： | 1 |
| 9 | Subcutaneous thigh fat necrosis as a result of tourniquet control during total knee arthro- plasty显示文摘 | Tamvakopoulos GS Toms AP Glasgow M | 2005 | Ann R Coll Surg Engl2005，87，5： | 1 |
| 10 | Reducing the effects of metal artifact using high keV monoenergetic reconstruction of dual energy CT (DECT) in hip replacements 显示文摘 | Lews M Reid K Toms AP | 2013 | Skelet Radiol2013，42，2： | 1 |
| 11 | MR imaging of acute anterior cruciate ligament injuries 显示文摘 | Klass D Toms AP Greenwood R | 2007 | Knee2007，14，5： | 1 |
| 12 | Illustrated review of new imaging techniques in the diagnosis of abdominal wall hernia显示文摘 | Toms AP Dixon AK Murphy JM | 1999 | BrJSurg1999，86，10： | 1 |
| 13 | Illustrated review of new imaging techniques in the diagnosis of abdominal wall hernias (review)显示文摘 | Toms AP Dixon AK Murph JMP | | 0，，： | 1 |
| 14 | A reliability study of measure- ment tools available on standard picture arehiving and communication system workstations for the evaluation of hip radiographs following ar- throplasty 显示文摘 | Patel SR Toms AP Rehman JM | 2011 | J Bone Joint Surg Am2011，93，： | 1 |
| 15 | MRI of early symptomatic met- al - on - metal total hip arthroplasty: a retrospective review of radio- logical findings in 20 hips显示文摘 | Toms AP Marshall TJ Cahir J | 2008 | Clin Radiol2008，1，： | 1 |
| 16 | Accuracy of magnetic reso- nance imaging, magnetic resonance arthrography and computed tomography for the detection of ehondral lesions of the knee 显示文摘 | Smith TO Drew BT Toms AP | 2012 | Knee Surg Sports Traumatol Arthrosc2012，20，12： | 1 |
| 17 | The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrog- raphy: a meta-analysis显示文摘 | Smith TO Hilton G Toms AP | 2011 | Eur Radiol2011，21，4： | 1 |
| 18 | Illustruated Review of New Imaging Techniques in Diagnosis of Abdominal Wall Hernia 显示文摘 | Toms AP Dixon AK Murphy JM | 1999 | Br J Surg1999，86，10： | 1 |
| 19 | CT and MRI of hip arthroplasty显示文摘 | Cahir JG Toms AP Marshall TJ | | 0，，： | 1 |
| 20 | Grading the severity of soft tissue changes associated with metal-on-metal hip replacements: reliability of an MR grading system 显示文摘 | Anderson H Toms AP Cabir JG | 2011 | Skeletal Radiol2011，40，： | 1 |
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