IMPACT OF AGE AND SEX ON SURVIVAL AFTER CURATIVE RESECTION FOR CARCINOMA OF THE ESOPHAGUS

Background. The impact of age and sex-related changes in the endogenou s hormonal milieu on survival after curative resection for esophageal epithelial cancer is explored. Adami et al. have suggested that the ev ent of puberty has a favorable impact on survival after treatment of e pithelial cancers. Methods. The database consisted of 469 patients wit h esophageal cancer treated surgically with an intent to cure (without any gross residual disease at the end of the primary treatment) at Ta ta Memorial Hospital between 1980 and 1989.Results. Life-table analysi s revealed a significantly better 5-year survival for women younger th an 49 years (35%, CI 24-48) compared with men of the same age (16%, CI 8-27) (P < 0.008). There was no difference in survival between men (1 7%, CI 12-23) and women (26%, CI 16-37) older than 49 years (P = 0.08) . A Cox proportional hazard model showed sex to be the second most sig nificant determinant of survival (P = 0.002) after lymph node metastas is (P < 0.0001). Conclusion. The finding that the survival benefit is confined to women younger than 49 years is consistent with the hypothe sis that the endocrine milieu in premenopausal women may prevent the e stablishment of micrometastases and thus improve the prognosis for eso phageal epithelial cancer.