Abstract
Background and objectives: Oesophageal carcinoma (OC) is a leading cancer in Sri Lanka. Despite the advancements in treatment, survival of patients with OC is reported to remain low. Thus, obtaining an insight into the survival and its prognostic factors is essential for policy making.
Methods: All newly diagnosed cases of OC at the National Cancer Institute Maharagama during the period of May 2015 to May 2016 (n=110) were followed up for one year to assess their survival. Univariate Kaplan-Meier Survival analysis (Log Rank test) was used to assess the survival of demographic, socio-economic and clinical subgroups; and subgroups of population-specific risk factor profile for OC in Sri Lanka. In multivariate analysis, Cox-Proportional Regression was used to assess the Hazard Ratios (HR) of the prognostic factors of survival.
Results: One-year survival rate of the participants was 8.2% with median survival of four months (95% CI: 3.2, 4.8). Univariate analysis revealed that those of less than 60 years (p=0.006), with secondary or higher education (p=0.017), with monthly income >Rs. 20,000 (p=0.026), having adenocarcinoma (p=0.001), of stage I disease (p<0.001), undergone surgery (p<0.001), never smoked (p=0.044) and having high total lifetime sports and exercise activity level (p<0.001) had increased survival. Cox-Regression analysis revealed that being 60 years or older (HR=1.713;p=0.012), having primary or lower education (HR=1.702; p=0.027); with low lifetime sports and exercise activity level (HR=2.32;p=0.004); undergone palliative treatment only (HR=46.546; p<0.001), chemotherapy (HR=2.902; p=0.003) or radiotherapy (HR=6.696; p<0.001) were independent prognostic factors for survival among OC patients.
Conclusions: oesophageal carcinoma is a disease with poor prognosis. Implementation of community-based novel mechanisms to improve physical activity in the general public, detection of OC early focusing on the vulnerable population and development of new treatment guidelines to improve survival of the OC patients are recommended.