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| 1 | Trends in treatment and overall survival among patients with proximal esophageal cancer显示文摘BACKGROUND The management of proximal esophageal cancer differs from that of tumors located in the mid and lower part of the esophagus due to the close vicinity of vital structures.Non-surgical treatment options like radiotherapy and definitive chemoradiation(CRT)have been implemented.The trends in(non-)surgical treatment and its impact on overall survival(OS)in patients with proximal esophageal cancer are unclear,related to its rare disease status.To optimize treatment strategies and counseling of patients with proximal esophageal cancer,it is therefore essential to gain more insight through real-life studies.AIM To establish trends in treatment and OS in patients with proximal esophageal cancer.METHODS In this population-based study,patients with proximal esophageal cancer diagnosed between 1989 and 2014 were identified in the Netherlands Cancer Registry.The proximal esophagus consists of the cervical esophagus and the upper thoracic section,extending to 24 cm from the incisors.Trends in radiotherapy,chemotherapy,and surgery,and OS were assessed.Analyses were stratified by presence of distant metastasis.Multivariable Cox proportional hazards regression analyses was performed to assess the effect of period of diagnosis on OS,adjusted for patient,tumor,and treatment characteristics.RESULTS In total,2783 patients were included.Over the study period,the use of radiotherapy,resection,and CRT in non-metastatic disease changed from 53%,23%,and 1%in 1989-1994 to 21%,9%,and 49%in 2010-2014,respectively.In metastatic disease,the use of chemotherapy and radiotherapy increased over time.Median OS of the total population increased from 7.3 mo[95%confidence interval(CI):6.4-8.1]in 1989-1994 to 9.5 mo(95%CI:8.1-10.8)in 2010-2014(logrank P<0.001).In non-metastatic disease,5-year OS rates improved from 5%(95%CI:3%-7%)in 1989-1994 to 13%(95%CI:9%-17%)in 2010-2014(logrank P<0.001).Multivariable regression analysis demonstrated a significant treatment effect over time on survival.In metastatic disease,median OS was 3.8 mo(95%CI:2.5-5.1)in 1989-1994,and 5.1 mo(95%CI:4.3-5.9)in 2010-2014(logrank P=0.26).CONCLUSION OS significantly improved in non-metastatic proximal esophageal cancer,likely to be associated with an increased use of CRT.Patterns in metastatic disease did not change significantly over time. | Judith de Vos-Geelen Sandra ME Geurts Liselot BJ Valkenburg-van Iersel Evelien JM de Jong Vivianne CG Tjan-Heijnen Margreet van Putten Valery EPP Lemmens Heike I Grabsch Nadia Haj Mohammad Frank JP Hoebers Chantal V Hoge Paul M Jeene Hanneke WM van Laarhoven Tom Rozema Marije Slingerland Grard AP Nieuwenhuijzen | 2019 | World Journal of Gastroenterology2019，25，47： | 2 |
| 2 | Deregulation of p27 by oncogenic signaling and its prognostic significance in breast cancer显示文摘 | Slingerland J | 2004 | Breast Cancer Res2004，6，1： | 1 |
| 3 | Evaluating hazard of landslide-induced water waves显示文摘 | Slingerland R Voight B | 1982 | Journal of the Waterway Port Coastal and Ocean Division1982，108，4： | 1 |
| 4 | Cytokines, Obesity, and Cancer: New Insights on Mechanisms Linking Obesity to Cancer Risk and Progression显示文摘 | Candace A. Gilbert Joyce M. Slingerland | 2013 | Annual Review of Medicine2013，，： | 1 |
| 5 | Multiple roles of the PI3K/PKB (Akt) pathway in cell cycle progression 显示文摘 | Liang J Slingerland JM | 2003 | Cell Cycle2003，2，4： | 1 |
| 6 | PTEN deficiency: a role in mammary carcinogenesis 显示文摘 | Petrocelli T Slingerland JM | 2001 | Breast Cancer Res2001，3，6： | 1 |
| 7 | Six of eight hemoglobin A1c point-of-care instruments do not meet the general accepted analytical performance criteria显示文摘 | Lenters-Westra E Slingerland RJ | 2010 | Clin Chem2010，56，： | 1 |
| 8 | Measuring the performance of multimedia instruction sets显示文摘 | Slingerland N Smith A J | 2002 | IEEE Transactions on Computers2002，51，11： | 1 |
| 9 | Multiple roles of the PI3K/PKB (Akt) pathway in cell cycle progression显示文摘 | Liang J Slingerland JM | 2003 | Cell Cycle2003，2，4： | 1 |
| 10 | Four storm-event beds and the tropical cyclones that produced them: A numerical hindcast 显示文摘 | Keen T R Slingerland R L | 1993 | Journal of Sedimentary Petrology1993，63，2： | 1 |
| 11 | The Cdk inhibitor p27kip1 in human cancer: prognostic potential and relevance to anticancer therapy显示文摘 | Chu IM Hengst L Slingerland JM | 2008 | Nat Rev Cane2008，8，4： | 1 |
| 12 | Referral rates for diag- nostic testing support an incidence of permanent neonatal diabetes in three European countries of at least 1 in 260,000 live births 显示文摘 | Slingerland AS Shields BM Flanagan SE | 2009 | Diabetologia2009，52，8： | 1 |
| 13 | Regulation of the CD Kinhibitor p27 and its deregulation in cancer显示文摘 | SLINGERLAND J PAGANO M | 2000 | J Cell Physiol2000，183，1： | 1 |
| 14 | Nexl-generation roTOR inhibitiors in clinical ontology: how pathway complexity informs theraputic stragey显示文摘 | Wander SA Hennessv BT Slingerland JM | 2011 | J Clin Invest2011，121，4： | 1 |
| 15 | Stream profile adjust- ment to crustal warping: nonlinearresults from a simple model 显示文摘 | SNOW R S SLINGERLAND R L | 1990 | Journal of Geology1990，98，： | 1 |
| 16 | Transforming activity of mutant human p53 alleles显示文摘 | Slingerland JM Benchimol S | 1991 | J Cell Physiol1991，148，3： | 1 |
| 17 | Erosional dynamics,flexural isostasy, and long-lived escarpments: A numerical modeling study显示文摘 | TUCKER G E SLINGERLAND R L | 1994 | Journal of Geophysical Research1994，99，12： | 1 |
| 18 | Reduced levels of the cellcycle inhibitor p27KIP1 in epithelial dysplasia and carcinoma of the oral cavity显示文摘 | Jordan RC Bradley G Slingerland J | 1998 | Am J Pathol1998，152，2： | 1 |
| 19 | Terahertz absorption spectra of nitromethane显示文摘 | Slingerland E J Jahngen E G E Goyette T M | 2011 | Journal of Quantitative Spectroscopy & Radiative Transfer2011，112，： | 1 |
| 20 | Multiple roles of the PI3K/PKB (Akt) pathway in cell cycle progression 显示文摘 | Liang J Slingerland JM | 2003 | Cell Cycle2003，2，4： | 1 |
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