Life Expectancy in Survivors of Esophageal Cancer Compared with the Background Population

Abstract

It is unknown whether the survival of patients cured of esophageal cancer differs from that of the corresponding background population. This nationwide and population-based cohort study included all patients who survived for at least 5 years after surgery for esophageal cancer in Sweden between 1987 and 2015, with follow-up throughout 2020. Relative survival rates with 95% confidence intervals (95% CI) were calculated by dividing the observed with the expected survival. The expected survival was assessed from the entire Swedish population of the corresponding age, sex, and calendar year. Yearly relative survival rates were calculated between 6 and 10 years postoperatively. Among all 762 participants, the relative survival was initially similar to the background population (96.1%, 95% CI 94.3–97.9%), but decreased each following postoperative year to 83.5% (95% CI 79.5–87.6%) by year 10. The drop in relative survival between 6 and 10 years was more pronounced in participants with a history of squamous cell carcinoma [from 94.5% (95% CI 91.2–97.8%) to 70.8% (95% CI 64.0–77.6%)] than in those with adenocarcinoma [from 96.9% (95% CI 94.8–99.0%) to 91.5% (95% CI 86.6–96.3%)], and in men [from 96.0% (95% CI 93.8–98.1%) to 81.8% (95% CI 76.8–86.8%)] than in women [from 96.4% (95% CI 93.4–99.5%) to 88.1% (95% CI 81.5–94.8%)]. No major differences were found between age groups. In conclusion, esophageal cancer survivors had a decline in survival between 6 and 10 years after surgery compared with the corresponding general population, particularly those with a history of squamous cell carcinoma of the esophagus and male sex.