NATIONAL-CANCER-DATA-BASE REPORT ON ESOPHAGEAL-CARCINOMA

BACKGROUND. The prognosis for patients with esophageal carcinoma is po or, with less than fifty percent surviving 1 year after diagnosis. Alt hough diagnostic and staging methods have improved, a large proportion of patients present with advanced disease. Research is being conducte d to determine what multimodality treatment regimens provide the best local control and survival. METHODS. Using the National Cancer Data Ba se's most current accrual of oncologic data for cases diagnosed in 198 8 and 1993, patterns of care and outcome were analyzed for esophageal carcinoma. RESULTS. A substantial increase was demonstrated between 19 88 and 1993 in the proportion of esophageal adenocarcinomas and patien ts presenting with Stage IV disease. The therapeutic regimen most freq uently employed in 1993 was combined radiation therapy and chemotherap y, which rose 8.2% from 22% in 1988. CONCLUSIONS. The dramatic rise ac ross the years of this study in the occurrence of esophageal adenocarc inomas indicates a need for developing strategies to evaluate Barrett' s preneoplastic mucosal changes more precisely. The increasing use of combined chemotherapy and radiation therapy reflects the results of ra ndomized trials that have demonstrated improved response and outcome f or this combined regimen compared with radiation therapy alone, There was no substantial increase in the use of surgical resection with chem otherapy and radiation therapy throughout these years. (C) 1996 Americ an Cancer Society.