P0514 - Incidence and Survival Trends in Esophageal Squamous Cell Carcinoma and Adenocarcinoma Over the Past 2 Decades Based on Location of the Tumor: A Retrospective Study

Sai Shanmukha Sreeram Pannala, MD¹, Medha Rajamanuri, MBBS², Liliane Deeb, MD^1
1Staten Island University Hospital, Northwell Health, Staten Island, NY; ²Southern Illinois University, Springfield, IL

Introduction: Esophageal cancers comprise up to 6% of GI cancers. Most patients are asymptomatic during the initial stages and usually present with advanced disease. This is taking a toll on survival outcomes which depend on the disease stage at diagnosis. Recently, we observed a shift from Squamous Cell Carcinoma (SCC) to Adenocarcinoma (AC) type. Keeping this in mind, we conducted a comprehensive retrospective study, to analyze the trends in incidence and survival based on the tumor's location in the esophagus.

Methods: Esophageal SCC and AC cases diagnosed from 2000 to 2020 were identified using SEER 22(excl IL & MA) registries, Nov 2022 submission. Malignant primary tumors were selected using pertinent ICD-O-3 codes and primary site codes for the esophagus's upper, middle, and lower thirds. Using SEER*Stat software version 8.4.3, the weighted least squares method determined Annual percent change (APC) in incidence. Relative survival rates at 60 months were calculated using Ederer II method. SE < 5% were considered statistically significant, excluding cases identified at autopsy or with no survival times.

Results: For AC, the APC for upper and middle thirds decreased (-0.67 and -0.57, respectively), while lower third showed an increasing APC of 0.75 (P< 0.05). For SCC, the APC in incidence decreased significantly across all thirds of the esophagus, with APCs of -0.36, -2.51, and -3.04, respectively (P< 0.05).

For SCC in the upper third, 5-year relative survival rates improved from 14.92% (2001-2010) to 21.42% (2011-2020); in middle third, from 14.97% to 20.98%; and in lower third, from 15.97% to 21.67% (all P< 0.05). For AC, in the upper third, 5-year relative survival rates changed from 23.93% (2001-2010) to 20.84% (2011-2020); in middle third, from 18.03% to 21.97%; and in lower third, from 21.17% to 24.55% (all P< 0.05).

Discussion: Our analysis revealed a significant decline in esophageal SCC across all segments, and mixed trends for AC, aligning with global direction, where distal esophageal ACs are increasing, likely due to the obesity pandemic; and SCC cancers are on a lower trend possibly secondary to emphasis on awareness for smoking & alcohol cessation. Improvements in survival rates across the board were observed, particularly in distal cancers, reflecting advancements in early detection tools and treatment methods. Further studies are warranted to shed more light on this subject and target early prevention and tailored treatment strategies to specific locations in the esophagus.


Disclosures:


Sai Shanmukha Sreeram Pannala, MD¹, Medha Rajamanuri, MBBS², Liliane Deeb, MD¹. P0514 - Incidence and Survival Trends in Esophageal Squamous Cell Carcinoma and Adenocarcinoma Over the Past 2 Decades Based on Location of the Tumor: A Retrospective Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.