| Peer-Reviewed

Sex Is Related to Overall Survival in Patients with Esophageal Squamous Cell Carcinoma: A Population-Based Study

Received: 8 January 2021    Accepted: 18 January 2021    Published: 25 January 2021
Views:       Downloads:
Abstract

Esophageal cancer is one of the cancers that seriously threaten the lives and health of patients around the world. Squamous cell carcinoma accounts for a higher proportion of esophageal cancer cases. At the same time, the number of esophageal squamous cell carcinoma (ESCC) patients also has an increasing trend year by year. Therefore, it is important to identify the prognostic factors of ESCC to improve the survival and prognosis of patients. As an important sociodemographic factor, gender has an important influence on the occurrence, development and prognosis of certain diseases. However, it has not been clear from existing studies whether gender affects the prognosis of ESCC patients. The aim of this study was to determine the effect of sex on overall survival (OS) in patients with ESCC. Methods: This study analyzed 6890 patients with ESCC diagnosed from 2007 to 2015 who were identified in the SEER (Surveillance, Epidemiology, and End Results) database. Kaplan-Meier method and Cox Proportional Hazards model were used to conduct survival analysis and regression analysis to evaluate the association between gender and OS. Results: We found that the OS differed with sex in patients with ESCC, with the 5-year OS rate being higher in females (19.2%) than in males (12.9%). A Cox multivariate analysis showed that sex was an independent prognostic factor for ESCC, with the OS being significantly better in female patients than in male patients (P<0.001). Subgroup analyses showed that sex affected the survival rate of patients with American Joint Committee on Cancer tumor, node, and metastasis stages I (P=0.013), II (P<0.001), III (P=0.014), and IV (P<0.001). Conclusion: Our results suggest that the OS of patients with ESCC is significantly better in females than males. Therefore, more attention should be paid to the prognosis of male patients with ESCC, with prospective interventions and health education applied in order to improve their survival outcomes.

Published in American Journal of Biomedical and Life Sciences (Volume 9, Issue 1)
DOI 10.11648/j.ajbls.20210901.16
Page(s) 43-52
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sex, Esophageal Squamous Cell Carcinoma, Survival, Prognosis, Database

References
[1] Global Burden of Disease Cancer C, Fitzmaurice C, Allen C, et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2017; 3 (4): 524-48 doi: 10.1001/jamaoncol.2016.5688 [published Online First: 2016/12/06].
[2] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69 (1): 7-34 doi: 10.3322/caac.21551 [published Online First: 2019/01/09].
[3] Then EO, Lopez M, Saleem S, et al. Esophageal Cancer: An Updated Surveillance Epidemiology and End Results Database Analysis. World J Oncol 2020; 11 (2): 55-64 doi: 10.14740/wjon1254 [published Online First: 2020/04/15].
[4] Napier KJ, Scheerer M, Misra S. Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities. World J Gastrointest Oncol 2014; 6 (5): 112-20 doi: 10.4251/wjgo.v6.i5.112 [published Online First: 2014/05/17].
[5] Pennathur A, Luketich JD. Resection for esophageal cancer: strategies for optimal management. Ann Thorac Surg 2008; 85 (2): S751-6 doi: 10.1016/j.athoracsur.2007.11.078 [published Online First: 2008/01/29].
[6] Qiu W, Chen J, Huang X, et al. The analysis of the lipid levels in patients with coronary artery disease after percutaneous coronary intervention: a one-year follow-up observational study. Lipids Health Dis 2020; 19 (1): 163 doi: 10.1186/s12944-020-01340-5 [published Online First: 2020/07/08].
[7] Worni M, Martin J, Gloor B, et al. Does surgery improve outcomes for esophageal squamous cell carcinoma? An analysis using the surveillance epidemiology and end results registry from 1998 to 2008. J Am Coll Surg 2012; 215 (5): 643-51 doi: 10.1016/j.jamcollsurg.2012.07.006 [published Online First: 2012/10/23].
[8] Worni M, Castleberry AW, Gloor B, et al. Trends and outcomes in the use of surgery and radiation for the treatment of locally advanced esophageal cancer: a propensity score adjusted analysis of the surveillance, epidemiology, and end results registry from 1998 to 2008. Dis Esophagus 2014; 27 (7): 662-9 doi: 10.1111/dote.12123 [published Online First: 2013/08/14].
[9] Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. The Lancet Oncology 2011; 12 (7): 681-92 doi: 10.1016/s1470-2045(11)70142-5.
[10] Kauppila JH, Wahlin K, Lagergren P, et al. Sex differences in the prognosis after surgery for esophageal squamous cell carcinoma and adenocarcinoma. Int J Cancer 2019; 144 (6): 1284-91 doi: 10.1002/ijc.31840 [published Online First: 2018/09/01].
[11] Gavin AT, Francisci S, Foschi R, et al. Oesophageal cancer survival in Europe: a EUROCARE-4 study. Cancer Epidemiol 2012; 36 (6): 505-12 doi: 10.1016/j.canep.2012.07.009 [published Online First: 2012/08/23].
[12] Eder L, Thavaneswaran A, Chandran V, et al. Gender difference in disease expression, radiographic damage and disability among patients with psoriatic arthritis. Ann Rheum Dis 2013; 72 (4): 578-82 doi: 10.1136/annrheumdis-2012-201357 [published Online First: 2012/05/17].
[13] Fajkovic H, Halpern JA, Cha EK, et al. Impact of gender on bladder cancer incidence, staging, and prognosis. World J Urol 2011; 29 (4): 457-63 doi: 10.1007/s00345-011-0709-9 [published Online First: 2011/06/10].
[14] Sundermann E E, Biegon A, Rubin L H, et al. Better verbal memory in women than men in MCI despite similar levels of hippocampal atrophy. Neurology 2016; 86 (15): 1368-1376 doi: 10.1212/WNL.0000000000002570 [published Online First: 2016/03/16].
[15] Nebel RA, Aggarwal NT, Barnes LL, et al. Understanding the impact of sex and gender in Alzheimer's disease: A call to action. Alzheimers Dement 2018; 14 (9): 1171-83 doi: 10.1016/j.jalz.2018.04.008 [published Online First: 2018/06/17].
[16] Zhang W, Jin K, Wang F, et al. Differences in the prognostic value of tumor size on hepatocellular cancer-specific survival stratified by gender in a SEER population-based study. United European Gastroenterol J 2019; 7 (7): 933-41 doi: 10.1177/2050640619845602 [published Online First: 2019/08/21].
[17] Afshar N, English DR, Thursfield V, et al. Differences in cancer survival by sex: a population-based study using cancer registry data. Cancer Causes Control 2018; 29 (11): 1059-69 doi: 10.1007/s10552-018-1079-z [published Online First: 2018/09/09].
[18] Tramontano AC, Nipp R, Mercaldo ND, et al. Survival Disparities by Race and Ethnicity in Early Esophageal Cancer. Dig Dis Sci 2018; 63 (11): 2880-88 doi: 10.1007/s10620-018-5238-6 [published Online First: 2018/08/16].
[19] Wang N, Bu Q, Yang J, et al. Insurance status is related to overall survival in patients with small intestine adenocarcinoma: A population-based study. Curr Probl Cancer 2020; 44 (1): 100505 doi: 10.1016/j.currproblcancer.2019.100505 [published Online First: 2019/09/25].
[20] Doll KM, Rademaker A, Sosa JA. Practical Guide to Surgical Data Sets: Surveillance, Epidemiology, and End Results (SEER) Database. JAMA Surg 2018; 153 (6): 588-89 doi: 10.1001/jamasurg.2018.0501 [published Online First: 2018/04/05].
[21] You H, Yang J, Liu Q, et al. The impact of the lymph node density on overall survival in patients with Wilms' tumor: a SEER analysis. Cancer Manag Res 2018; 10: 671-77 doi: 10.2147/CMAR.S163514 [published Online First: 2018/04/20].
[22] Westwick HJ, Shamji MF. Effects of sex on the incidence and prognosis of spinal meningiomas: a Surveillance, Epidemiology, and End Results study. J Neurosurg Spine 2015; 23 (3): 368-73 doi: 10.3171/2014.12.SPINE14974 [published Online First: 2015/05/30].
[23] Brusselaers N, Maret-Ouda J, Konings P, et al. Menopausal hormone therapy and the risk of esophageal and gastric cancer. Int J Cancer 2017; 140 (7): 1693-99 doi: 10.1002/ijc.30588 [published Online First: 2016/12/23].
[24] Sukocheva OA, Li B, Due SL, et al. Androgens and esophageal cancer: What do we know? World J Gastroenterol 2015; 21 (20): 6146-56 doi: 10.3748/wjg.v21.i20.6146 [published Online First: 2015/06/03].
[25] Nipp R, Tramontano AC, Kong CY, et al. Disparities in cancer outcomes across age, sex, and race/ethnicity among patients with pancreatic cancer. Cancer Med 2018; 7 (2): 525-35 doi: 10.1002/cam4.1277 [published Online First: 2018/01/13].
[26] Zeng C, Wen W, Morgans AK, et al. Disparities by Race, Age, and Sex in the Improvement of Survival for Major Cancers: Results From the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program in the United States, 1990 to 2010. JAMA Oncol 2015; 1 (1): 88-96 doi: 10.1001/jamaoncol.2014.161 [published Online First: 2015/07/17].
[27] Innos K, Padrik P, Valvere V, et al. Sex differences in cancer survival in Estonia: a population-based study. BMC Cancer 2015; 15: 72 doi: 10.1186/s12885-015-1080-9 [published Online First: 2015/04/18].
[28] Hambraeus G M, Mercke C E, Willen R, et al. Prognostic factors influencing survival in combined radiotherapy and surgery of squamous cell carcinoma of the esophagus with special reference to a histopathologic grading system. Cancer 1988; 62 (5): 895-904 doi: 10.1002/1097-0142(19880901)62:5<895::aid-cncr2820620508>3.0.co;2-0. [published Online First: 1988/03/02]
[29] Yang HX, Ling L, Zhang X, et al. Outcome of elderly patients with oesophageal squamous cell carcinoma after surgery. Br J Surg 2010; 97 (6): 862-7 doi: 10.1002/bjs.7005 [published Online First: 2010/03/20].
[30] Chang DT, Chapman C, Shen J, et al. Treatment of esophageal cancer based on histology: a surveillance epidemiology and end results analysis. Am J Clin Oncol 2009; 32 (4): 405-10 doi: 10.1097/COC.0b013e3181917158 [published Online First: 2009/05/06].
[31] Haberlin C, O'Dwyer T, Mockler D, et al. The use of eHealth to promote physical activity in cancer survivors: a systematic review. Support Care Cancer 2018; 26 (10): 3323-36 doi: 10.1007/s00520-018-4305-z [published Online First: 2018/06/18].
[32] Perry AM, Brunner AM, Zou T, et al. Association between insurance status at diagnosis and overall survival in chronic myeloid leukemia: A population-based study. Cancer 2017; 123 (13): 2561-69 doi: 10.1002/cncr.30639 [published Online First: 2017/05/04].
[33] Zhang J, Jiang Y, Wu C, et al. Comparison of clinicopathologic features and survival between eastern and western population with esophageal squamous cell carcinoma. J Thorac Dis 2015; 7 (10): 1780-6 doi: 10.3978/j.issn.2072-1439.2015.10.39 [published Online First: 2015/12/02].
[34] Padrao P, Damasceno A, Silva-Matos C, et al. Alcohol consumption in Mozambique: regular consumption, weekly pattern and binge drinking. Drug Alcohol Depend 2011; 115 (1-2): 87-93 doi: 10.1016/j.drugalcdep.2010.10.010 [published Online First: 2010/12/03].
[35] Soler Vila H, Galán I, Valencia Martín J L, et al. Binge Drinking in Spain, 2008–2010. Alcoholism: Clinical and Experimental Research 2014; 38 (3): 810-819 doi: 10.1111/acer.12275 [published Online First: 2013/10/24].
[36] Freedman ND, Abnet CC, Leitzmann MF, et al. A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes. Am J Epidemiol 2007; 165 (12): 1424-33 doi: 10.1093/aje/kwm051 [published Online First: 2007/04/11].
[37] Mena S, Ortega A, Estrela JM. Oxidative stress in environmental-induced carcinogenesis. Mutat Res 2009; 674 (1-2): 36-44 doi: 10.1016/j.mrgentox.2008.09.017 [published Online First: 2008/11/04].
[38] Hecht SS. Progress and challenges in selected areas of tobacco carcinogenesis. Chem Res Toxicol 2008; 21 (1): 160-71 doi: 10.1021/tx7002068 [published Online First: 2007/12/07].
[39] Ben-Eliyahu S, Page GG, Yirmiya R, Taylor AN. Acute alcohol intoxication suppresses natural killer cell activity and promotes tumor metastasis. Nat Med. 1996, 2 (4): 457-460 doi: 10.1038/nm0496-457 [published Online First: 1996/04/01].
[40] Lambot M A, Peny M O, Fayt I, et al. Overexpression of 27-kDa heat shock protein relates to poor histological differentiation in human oesophageal squamous cell carcinoma. Histopathology. 2000; 36 (4): 326-330 doi: 10.1046/j.1365-2559.2000.00858.x [published Online First: 2001/12/25].
[41] Hidaka H, Hotokezaka M, Nakashima S, et al. Sex difference in survival of patients treated by surgical resection for esophageal cancer. World J Surg 2007; 31 (10): 1982-7 doi: 10.1007/s00268-007-9193-1 [published Online First: 2007/08/07].
[42] Haisley KR, Hart KD, Fischer LE, et al. Increasing tumor length is associated with regional lymph node metastases and decreased survival in esophageal cancer. Am J Surg 2016; 211 (5): 860-6 doi: 10.1016/j.amjsurg.2016.01.007 [published Online First: 2016/03/20].
[43] Arce PM, Camilon PR, Stokes WA, et al. Is sex an independent prognostic factor in cutaneous head and neck melanoma? Laryngoscope 2014; 124 (6): 1363-7 doi: 10.1002/lary.24439 [published Online First: 2013/10/15].
[44] Xie SH, Lagergren J. Risk factors for oesophageal cancer. Best Pract Res Clin Gastroenterol 2018; 36-37: 3-8 doi: 10.1016/j.bpg.2018.11.008 [published Online First: 2018/12/16].
Cite This Article
  • APA Style

    Yaoxia Li, Na Wang, Zhuorui Zhao, Jiale Wang, Jun Lyu, et al. (2021). Sex Is Related to Overall Survival in Patients with Esophageal Squamous Cell Carcinoma: A Population-Based Study. American Journal of Biomedical and Life Sciences, 9(1), 43-52. https://doi.org/10.11648/j.ajbls.20210901.16

    Copy | Download

    ACS Style

    Yaoxia Li; Na Wang; Zhuorui Zhao; Jiale Wang; Jun Lyu, et al. Sex Is Related to Overall Survival in Patients with Esophageal Squamous Cell Carcinoma: A Population-Based Study. Am. J. Biomed. Life Sci. 2021, 9(1), 43-52. doi: 10.11648/j.ajbls.20210901.16

    Copy | Download

    AMA Style

    Yaoxia Li, Na Wang, Zhuorui Zhao, Jiale Wang, Jun Lyu, et al. Sex Is Related to Overall Survival in Patients with Esophageal Squamous Cell Carcinoma: A Population-Based Study. Am J Biomed Life Sci. 2021;9(1):43-52. doi: 10.11648/j.ajbls.20210901.16

    Copy | Download

  • @article{10.11648/j.ajbls.20210901.16,
      author = {Yaoxia Li and Na Wang and Zhuorui Zhao and Jiale Wang and Jun Lyu and Qinyang Wu and Qiqi Ke and Qiaohong Yang},
      title = {Sex Is Related to Overall Survival in Patients with Esophageal Squamous Cell Carcinoma: A Population-Based Study},
      journal = {American Journal of Biomedical and Life Sciences},
      volume = {9},
      number = {1},
      pages = {43-52},
      doi = {10.11648/j.ajbls.20210901.16},
      url = {https://doi.org/10.11648/j.ajbls.20210901.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbls.20210901.16},
      abstract = {Esophageal cancer is one of the cancers that seriously threaten the lives and health of patients around the world. Squamous cell carcinoma accounts for a higher proportion of esophageal cancer cases. At the same time, the number of esophageal squamous cell carcinoma (ESCC) patients also has an increasing trend year by year. Therefore, it is important to identify the prognostic factors of ESCC to improve the survival and prognosis of patients. As an important sociodemographic factor, gender has an important influence on the occurrence, development and prognosis of certain diseases. However, it has not been clear from existing studies whether gender affects the prognosis of ESCC patients. The aim of this study was to determine the effect of sex on overall survival (OS) in patients with ESCC. Methods: This study analyzed 6890 patients with ESCC diagnosed from 2007 to 2015 who were identified in the SEER (Surveillance, Epidemiology, and End Results) database. Kaplan-Meier method and Cox Proportional Hazards model were used to conduct survival analysis and regression analysis to evaluate the association between gender and OS. Results: We found that the OS differed with sex in patients with ESCC, with the 5-year OS rate being higher in females (19.2%) than in males (12.9%). A Cox multivariate analysis showed that sex was an independent prognostic factor for ESCC, with the OS being significantly better in female patients than in male patients (PP=0.013), II (PP=0.014), and IV (P<0.001). Conclusion: Our results suggest that the OS of patients with ESCC is significantly better in females than males. Therefore, more attention should be paid to the prognosis of male patients with ESCC, with prospective interventions and health education applied in order to improve their survival outcomes.},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Sex Is Related to Overall Survival in Patients with Esophageal Squamous Cell Carcinoma: A Population-Based Study
    AU  - Yaoxia Li
    AU  - Na Wang
    AU  - Zhuorui Zhao
    AU  - Jiale Wang
    AU  - Jun Lyu
    AU  - Qinyang Wu
    AU  - Qiqi Ke
    AU  - Qiaohong Yang
    Y1  - 2021/01/25
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajbls.20210901.16
    DO  - 10.11648/j.ajbls.20210901.16
    T2  - American Journal of Biomedical and Life Sciences
    JF  - American Journal of Biomedical and Life Sciences
    JO  - American Journal of Biomedical and Life Sciences
    SP  - 43
    EP  - 52
    PB  - Science Publishing Group
    SN  - 2330-880X
    UR  - https://doi.org/10.11648/j.ajbls.20210901.16
    AB  - Esophageal cancer is one of the cancers that seriously threaten the lives and health of patients around the world. Squamous cell carcinoma accounts for a higher proportion of esophageal cancer cases. At the same time, the number of esophageal squamous cell carcinoma (ESCC) patients also has an increasing trend year by year. Therefore, it is important to identify the prognostic factors of ESCC to improve the survival and prognosis of patients. As an important sociodemographic factor, gender has an important influence on the occurrence, development and prognosis of certain diseases. However, it has not been clear from existing studies whether gender affects the prognosis of ESCC patients. The aim of this study was to determine the effect of sex on overall survival (OS) in patients with ESCC. Methods: This study analyzed 6890 patients with ESCC diagnosed from 2007 to 2015 who were identified in the SEER (Surveillance, Epidemiology, and End Results) database. Kaplan-Meier method and Cox Proportional Hazards model were used to conduct survival analysis and regression analysis to evaluate the association between gender and OS. Results: We found that the OS differed with sex in patients with ESCC, with the 5-year OS rate being higher in females (19.2%) than in males (12.9%). A Cox multivariate analysis showed that sex was an independent prognostic factor for ESCC, with the OS being significantly better in female patients than in male patients (PP=0.013), II (PP=0.014), and IV (P<0.001). Conclusion: Our results suggest that the OS of patients with ESCC is significantly better in females than males. Therefore, more attention should be paid to the prognosis of male patients with ESCC, with prospective interventions and health education applied in order to improve their survival outcomes.
    VL  - 9
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • School of Nursing, Jinan University, Guangzhou, China

  • School of Nursing and Health, Henan University, Kaifeng, China

  • School of Nursing, Jinan University, Guangzhou, China

  • School of Nursing, Jinan University, Guangzhou, China

  • Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • School of Nursing, Jinan University, Guangzhou, China

  • School of Nursing, Jinan University, Guangzhou, China

  • School of Nursing, Jinan University, Guangzhou, China

  • Sections