Improvement of esophageal cancer survival in Northeast Iran: A two-decade journey in a high-risk, low- resource region
- Study type
- Observational study
- Study name
- GEMINI
- Design
- Prospective cohort study of patients with oesophageal squamous-cell carcinoma with active and passive follow-up
- Sample size
- 490 patients
- Source
- PLoS ONE · 2024
In plain words
This study looked at survival of patients with squamous-cell cancer of the oesophagus in northeast Iran (Golestan Province). About 23% of patients were alive five years after diagnosis, whereas this figure had earlier been reported as about 3.3% in the same region. Patients who received cancer treatment, were younger or did not use opium survived longer on average. These findings show that access to proper care and treatment can improve outcomes.
Key results
Treatment arms and regimens
This is an observational study with no intervention group. Patients were compared by whether or not they received cancer treatment; details of treatment type and dose are in the full text.
Source of the regimen details: Abstract of the paper
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
490 adult patients with histologically confirmed oesophageal squamous-cell carcinoma (ESCC) enrolled between 2007 and 2018 from the Atrak Clinic in Golestan Province, Iran. Demographic data and various exposures were collected at enrolment.
Endpoints
Survival of patients with ESCC (5-year survival probability and median survival time) and prognostic factors associated with risk of death. Vital status was determined up to March 2019 through active follow-up (telephone interviews) and passive follow-up (linkage with the Golestan population-based cancer and death registries). Survival estimates were obtained with the Kaplan–Meier method and Cox proportional hazards regression models.
Safety and side effects
This is an observational survival study, and treatment adverse event data were not reported in the abstract.
Clinical significance and place in guidelines
This observational study shows that improved health infrastructure and access to affordable treatment were associated with a marked improvement in ESCC survival in a high-risk, low-resource region. Not receiving treatment (which may reflect advanced disease at diagnosis), opium use, older age and Turkmen ethnicity were associated with a worse prognosis. This study is not a clinical guideline and does not directly change treatment protocols, but it supports policies to strengthen access to diagnosis and treatment.
Limitations
Observational, single-centre design (Atrak Clinic); the comparison with the earlier report from the same region is a historical comparison. "Not receiving treatment" may be a marker of advanced disease and confound its association with survival. Details of treatment types and disease stage are not given in the abstract.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.