Female patients with locally advanced esophageal cancer, treated with chemoradiation therapy before surgery are expected to have a more favorable response to the treatment than male patients, say researchers. A study published in The Annals of Thoracic Surgery reports women with locally advanced esophageal cancer, treated with chemoradiation therapy prior to surgery, showed a superior response to the treatment, and lower risk of cancer recurrence than men.
Senior author K. Robert Shen of the Mayo Clinic in Rochester, said, "Esophageal cancer is one of the deadliest cancers in the world. It affects males and females differently. Men are more at risk to develop this cancer, and it appears that women respond better to the treatments."
According to the American Cancer Society (ACS), men are four times more likely to develop esophageal cancer than women. The ACS assessed around 16,940 (13,360 men and 3,580 women) new cases diagnosed with esophageal cancer with around 15,690 deaths (12,720 men and 2,970 women), in 2017. The risk of esophageal cancer was found to be 1:125 for men and 1:454 for women.
The research team led by Dr. Shen collated and analyzed data (between 1990 and 2013) of women with locally advanced esophageal cancer, they were treated with chemotherapy and radiation prior to surgery and compared with men.
The study involved 145 women (median age=64), 221 men (median age=61). Researchers diagnosed adenocarcinoma (cancer originating in gland cells/lower part of the esophagus) in 72% of women and 87% of men, and squamous cell carcinoma (cancer starting in cells that line the esophagus) in 28% of women and 13% of men.
Dr. Shen said that they have studied the largest group of women precisely to analyze the impact of gender on response to treatment and long-term outcomes. In the study men and women were matched based on certain characteristics to exclude possible confusing factors.
The study revealed that complete/near complete pathologic response shown by 58% of women and 47% of men. Additionally, cancer recurred in 32% of patients (38 female, 69 male) which indicates, men are having an 80% increased risk of recurrence. The study also showed that superior 5-year survival for women vs. men (52.1% vs. 44.0%), however, this did not reach statistical significance.
"The results of this study are intriguing because they suggest that by focusing on individualized and targeted approaches to esophageal cancer treatment, we may be more successful in improving outcomes for future patients,” Dr. Shen said. Most cancers affect people in various ways, a sign of mutations. Hence, further research is required, he added.
Dr. Shen concluded, "If the genetic or molecular basis that explains our findings can be elucidated, one can conceive of chemoradiation therapy regimens that are more targeted based on the genetic signatures of each patient's tumors." An individualized method for treatment of cancer is expected to treat many types of cancer, he added.