Gender Differences in Treatment Allocation and Survival of Advanced Gastroesophageal Cancer: A Population-Based Study.

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Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_949817C75DEC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Gender Differences in Treatment Allocation and Survival of Advanced Gastroesophageal Cancer: A Population-Based Study.
Journal
Journal of the National Cancer Institute
Author(s)
Dijksterhuis WPM, Kalff M.C., Wagner A.D., Verhoeven RHA, Lemmens VEPP, van Oijen MGH, Gisbertz S.S., van Berge Henegouwen M.I., van Laarhoven HWM
ISSN
1460-2105 (Electronic)
ISSN-L
0027-8874
Publication state
Published
Issued date
02/11/2021
Peer-reviewed
Oui
Volume
113
Number
11
Pages
1551-1560
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Biological sex and gender have been reported to affect incidence and overall survival (OS) of curatively treated gastroesophageal cancer. The aim of this study was to compare palliative treatment allocation and OS between women and men with advanced gastroesophageal cancer.
Patients with an unresectable or metastatic esophageal (including cardia) adenocarcinoma (EAC) or squamous cell carcinoma (ESCC) or gastric adenocarcinoma (GAC) diagnosed in 2015-2018 were identified in the Netherlands Cancer Registry. Treatment allocation was compared using χ2 tests and multivariable logistic regression analyses, and OS using the Kaplan-Meier method with log-rank test and Cox proportional hazards analysis. All statistical tests were 2-sided.
Of patients with EAC (n = 3077), ESCC (n = 794), and GAC (n = 1836), 18.0%, 39.4%, and 39.1% were women, respectively. Women less often received systemic treatment compared with men for EAC (42.7% vs 47.4%, P = .045) and GAC (33.8% vs 38.8%, P = .03) but not for ESCC (33.2% vs 39.5%, P = .07). Women had a lower probability of receiving systemic treatment for GAC in multivariable analyses (odds ratio [OR] = 0.79, 95% confidence interval [CI] = 0.62 to 1.00) but not for EAC (OR = 0.86, 95% CI = 0.69 to 1.06) and ESCC (OR = 0.81, 95% CI = 0.57 to 1.14). Median OS was lower in women with EAC (4.4 vs 5.2 months, P = .04) but did not differ after adjustment for patient and tumor characteristics and systemic treatment administration.
We observed statistically significant and clinically relevant gender differences in systemic treatment administration and OS in advanced gastroesophageal cancer. Causes of these disparities may be sex based (ie, related to tumor biology) as well as gender based (eg, related to differences in treatment choices).
Keywords
drug therapy, esophageal neoplasms, gastric neoplasms, gender identity, palliative treatment, sex
Pubmed
Open Access
Yes
Create date
04/05/2021 8:13
Last modification date
12/01/2022 7:12
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