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|Title:||Symptoms, investigations and management of patients with cancer of the oesophagus and gastro-oesophageal junction in Australia|
|Citation:||Medical Journal of Australia, 2010; 193(10):572-577|
|Publisher:||Australasian Medical Publishing Company|
|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; Adenocarcinoma; Carcinoma, Squamous Cell; Esophageal Neoplasms; Incidence; Prevalence; Neoplasm Staging; Sex Distribution; Aged; Cross-Sectional Studies; Deglutition Disorders|
|Rights:||© Australasian Medical Publishing Company|
|Appears in Collections:||Medicine publications|
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