Prognosis of oesophageal cancer

The prognosis for oesophageal carcinoma is dependent on the site of the tumour. Approximate 5-year survival figures are:

• upper third tumours have a 20% 5-year survival
• middle third tumours have a 6% 5-year survival
• lower third tumours have a 15% 5-year survival

The prognosis also depends on:

• tumour size and site
• depth of invasion
• node metastases
• widespread metastases
• tumour grade
• lymphocytic response
• general health of the patient

Population based cohort studies have reported a minor improvement of the overall prognosis in oesophageal cancer patients during the past 20 years (1)

• in the USA overall 5-year survival rate for patients with oesophageal adenocarcinoma is slightly higher (17%) than in squamous cell carcinoma (2)
• in England and Wales
  • more than a tenth (12%) of people diagnosed with oesophageal cancer in England and Wales survive their disease for ten years or more (2010-11)
  • 3 in 20 (15%) of people diagnosed with oesophageal cancer in England and Wales survive their disease for five years or more (2010-11)
  • more than 4 in 10 (42%) people diagnosed with oesophageal cancer in England and Wales survive their disease for one year or more (2010-11)
  • oesophageal cancer survival is higher in men than women at one-year, but similar at five- and ten-years
    • oesophageal cancer survival falls only slightly beyond five years after diagnosis, which means most patients can be considered cured after five years
      • 12% of men and 13% of women are predicted to survive their disease for ten years or more, as shown by age-standardised net survival for patients diagnosed with oesophageal cancer during 2010-2011 in England and Wales
      • out of 20 common cancers in England and Wales, ten-year survival for oesophageal cancer ranks 3rd lowest overall.
  • almost a fifth of men and more than a quarter of women in England diagnosed with oesophageal cancer aged 50-59 survive their disease for five years or more, compared with around 5 in 100 people diagnosed aged 80 and over (2009-2013). Oesophageal cancer survival is improving and has tripled in the last 40 years in the UK
  • in the 1970s, less than 5 in 100 people diagnosed with oesophageal cancer survived their disease beyond ten years, now it's more than a tenth

Reference:

• (1) Lagergren J, Lagergren P. Oesophageal cancer. BMJ. 2010;341:c6280.
• (2) Rustgi AK, El-Serag HB. Esophageal carcinoma. N Engl J Med. 2014;371(26):2499-509.
• (3) Cancer Research UK. Oesophageal cancer survival statistics. (Accessed 28/5/19)