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Wijesekera S, Alagiyawanna L, Peiris V, Silva DC, Rupasinghe T, Balawardena J, Skandarajah T, Jeyakumaran N, Gunasekera D, Bandusena M, Joseph N. Outcomes of patients with esophageal and gastric cancer in Sri Lanka: A retrospective survival analysis. J Cancer Res Ther 2023; 19:S294-S299. [PMID: 37148006 DOI: 10.4103/jcrt.jcrt_817_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Introduction Esophageal carcinoma is the fourth most common cancer among males and sixth most common cancer among females in Sri Lanka. Gastric cancer is less common, but its incidence is gradually rising. We conducted a retrospective analysis of survival of esophageal and gastric cancer patients treated at National Cancer Institute, Maharagama, Sri Lanka. Methodology Patients with esophageal and gastric cancer treated in three selected oncology units of the National Cancer Institute, Maharagama during 2015 and 2016 were included in the study. Data on clinical and pathological factors were extracted from clinical records. Overall survival (OS), defined as time to death or loss to follow-up, was the primary endpoint. Univariate and multivariate analyses of survival were performed using the log-rank test and Cox proportional-hazard model, respectively. Results The study population comprised 374 patients with a median age of 62 years (interquartile range 55-70). Majority (64%) were male and had squamous cell carcinoma (58%). In the sample, 20% were gastric cancers, while 71% were esophageal cancers, and 9% had gastro-esophageal junction tumors. The 2-year OS was 19% in patients treated with curative intent (95% confidence interval [CI] 14-26 months) with those receiving neoadjuvant chemotherapy, followed by radical surgery having the highest survival (P < 0.001, hazard ratio 0.25 [95% CI 0.11-0.56]). Median OS was 2 months (95% CI 1-2 months) in patients treated with palliative intent. Conclusion Our results suggest that the outcome of patients with esophageal and gastric cancer is poor in Sri Lanka. Early detection and greater utilization of multimodality treatment could improve outcomes of these patients.
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Affiliation(s)
- Sidath Wijesekera
- Department of Clinical Oncology, National Cancer Institute; Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Batticaloa, Sri Lanka
| | - Lanka Alagiyawanna
- Department of Clinical Oncology, National Cancer Institute; Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Batticaloa, Sri Lanka
| | - Vimukthini Peiris
- Department of Clinical Oncology, National Cancer Institute; Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Batticaloa, Sri Lanka
| | | | - Tiromi Rupasinghe
- Department of Clinical Oncology, National Cancer Institute; Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Batticaloa, Sri Lanka
| | - Jayantha Balawardena
- Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Batticaloa; Department of Clinical Oncology, General Sir John Kotalawela Defence University Hospital, Boralesgamuwa, Sri Lanka
| | - Thurairajah Skandarajah
- Department of Clinical Oncology, National Cancer Institute; Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Batticaloa, Sri Lanka
| | - Nadarajah Jeyakumaran
- Department of Clinical Oncology, National Cancer Institute; Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Batticaloa, Sri Lanka
| | - Dehan Gunasekera
- Department of Clinical Oncology, National Cancer Institute; Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Batticaloa, Sri Lanka
| | - Minoli Bandusena
- Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Batticaloa; Department of Surgical Oncology, Teaching Hospital, Anuradhapura, Sri Lanka
| | - Nuradh Joseph
- Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists; Department of Clinical Oncology, Teaching Hospital, Batticaloa, Sri Lanka
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