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Type: Journal article
Title: Symptoms, investigations and management of patients with cancer of the oesophagus and gastro-oesophageal junction in Australia
Author: Smithers, B.M.
Fahey, P.P.
Corish, T.
Gotley, D.C.
Falk, G.L.
Smith, G.S.
Kiroff, G.K.
Clouston, A.D.
Watson, D.I.
Whiteman, D.C.
Citation: Medical Journal of Australia, 2010; 193(10):572-577
Publisher: Australasian Medical Publishing Company
Issue Date: 2010
ISSN: 0025-729X
Statement of
Bernard M Smithers, Paul P Fahey, Tracie Corish, David C Gotley, Gregory L Falk, Garett S Smith, George K Kiroff, Andrew D Clouston, David I Watson and David C Whiteman
Abstract: OBJECTIVE: To document presenting symptoms, investigations and management for Australian patients with oesophageal adenocarcinoma (OAC), gastro-oesophageal junction adenocarcinoma (GOJAC) and oesophageal squamous cell carcinoma (OSCC). DESIGN, SETTING AND PARTICIPANTS: Cross-sectional study of a population-based sample of 1100 Australian patients aged 18-79 years with histologically confirmed oesophageal cancer diagnosed in 2002-2005, using data from cancer registries and treatment centres, supplemented with clinical information collected through medical record review in 2006-2007 and mortality information collected in 2008. MAIN OUTCOME MEASURES: Prevalence of primary symptoms, and staging investigations and treatment modalities used. RESULTS: The primary presenting symptom was dysphagia, which was self-reported by 41%, 39% and 48% of patients with OAC, GOJAC and OSCC, respectively. Less common symptoms were reflux, chest pain, bleeding and weight loss. All patients underwent endoscopy, most had a staging computed tomography scan (OAC 93%, GOJAC 95% and OSCC 93%), and about half had positron emission tomography scans (OAC 51%, GOJAC 44% and OSCC 42%). Pretreatment tumour stage was reported in 25% of records, and could be derived from results of investigations in a further 23%, but the remaining half lacked sufficient information to ascribe a pretreatment stage. Curative treatments were attempted for 60% of OAC, 88% of GOJAC and 65% of OSCC patients. Surgery was performed on 52% of OAC, 83% of GOJAC and 41% of OSCC patients. About two-thirds of surgical patients received additional therapies. CONCLUSIONS: With anticipated increases in oesophageal cancer incidence, the resources required to diagnose and manage patients with oesphageal cancer are also likely to rise. Our data provide a baseline from which to plan for the future care of patients with cancers of the oesophagus.
Keywords: Esophagogastric Junction
Carcinoma, Squamous Cell
Esophageal Neoplasms
Neoplasm Staging
Sex Distribution
Cross-Sectional Studies
Deglutition Disorders
Rights: © Australasian Medical Publishing Company
DOI: 10.5694/j.1326-5377.2010.tb04064.x
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