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Multidisciplinary cancer care may impact on the postoperative mortality and survival of patients with oesophageal and oesophagogastric junction cancer: a retrospective cohort study

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Abstract

Background

Modern management of Oesophageal and oesophagogastric junction (OGJ) cancers requires a multidisciplinary approach, which was implemented at our health centre in 2005. This study aimed to assess the impact of this change on clinical outcomes.

Methods

A retrospective cohort study was conducted, covering all patients treated for oesophageal and OGJ cancer at the cancer centre established by the Bellvitge University Hospital and Catalonian Institute of Oncology, over two time periods, i.e. 2000–2004 and 2005–2008. Descriptive and multivariate analyses were performed using survival at 1 and 3 years as dependent variables.

Results

Between 1 January 2000 and 31 December 2008, 586 patients were included. Number of patients with unknown stage at diagnosis was significantly reduced. Preoperative strategies at the oesophageal location clearly increased in the recent period. A multidisciplinary approach resulted in a significant reduction in surgical mortality (11.8 vs. 2 %) in the period 2005–2008. Analysis restricted to patients undergoing surgery with curative intent indicated a significant increase in 1- and 3-year survival in the latter period (68.4 vs. 89.8 and 38.2 vs. 57.1 %, respectively). Multivariate analysis showed that variables associated with improved survival were: age; tumour stage; radical intent of treatment (surgery and radical combined chemoradiotherapy); and therapeutic strategy.

Conclusion

Better selection of patients for therapy together with improved staging resulted in a significant improvement in 1- and 3-year survival in cases undergoing surgery with curative intent. These changes would support the adoption of a multidisciplinary approach to clinical decision-making in cases of oesophageal and OGJ cancer.

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Acknowledgments

We should like to thank all the professionals involved in the Multidisciplinary Oesophagogastric Tumour Committee & Unit of the Bellvitge University Teaching Hospital and Catalonian Institute of Oncology (Institut Català d’Oncologia - ICO), without whom this study would not have been possible. We are also grateful to Nuria Casas and Alba García for their invaluable task of data collection. This study was conducted within the framework of the Spanish Cancer Research Network (Red Temática de investigación Cooperativa en Cáncer - RTICC) of the Carlos III Health Institute (Instituto de Salud Carlos III) (RD 06/020/0089).

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Multidisciplinary Oesophagogastric Tumour Committee and Unit, Catalonian Institute of Oncology, IDIBELL, Barcelona, Spain

    M. Galán, G. Hormigo, A. M. Boladeras & M. Calvo

  2. Multidisciplinary Oesophagogastric Tumour Committee and Unit, Bellvitge University Teaching Hospital, IDIBELL, Barcelona, Spain

    L. Farran, H. Aranda, C. Bettonica, J. M. Botargues, G. Creus, M. E. De Lama, J. B. Gornals, R. Mast, M. Miró, M. J. Paúles, J. Robles & N. Virgili

  3. Department of Health, Catalonian Cancer Strategy, IDIBELL, Barcelona, Spain

    L. Aliste & J. M. Borràs

  4. Department of Clinical Sciences, IDIBELL, University of Barcelona, Barcelona, Spain

    J. M. Borràs

  5. Department of Medical Oncology, Catalan Institute of Oncology, IDIBELL, Avda. Gran Via de L’Hospitalet, 08908 - Hospitalet de Llobregat, 199-203, Barcelona, Spain

    M. Galán

Authors
  1. M. Galán
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  2. L. Farran
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  3. L. Aliste
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  4. G. Hormigo
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  5. H. Aranda
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  6. C. Bettonica
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  7. A. M. Boladeras
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  8. J. M. Botargues
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  9. M. Calvo
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  10. G. Creus
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  11. M. E. De Lama
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  12. J. B. Gornals
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  13. R. Mast
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  14. M. Miró
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  15. M. J. Paúles
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  16. J. Robles
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  17. N. Virgili
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  18. J. M. Borràs
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Corresponding author

Correspondence to M. Galán.

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Galán, M., Farran, L., Aliste, L. et al. Multidisciplinary cancer care may impact on the postoperative mortality and survival of patients with oesophageal and oesophagogastric junction cancer: a retrospective cohort study. Clin Transl Oncol 17, 247–256 (2015). https://doi.org/10.1007/s12094-014-1221-7

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  • DOI: https://doi.org/10.1007/s12094-014-1221-7

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