Comparison of Survival Status and Related Risk Factors of Esophageal Squamous Cell Carcinoma Patients Between High- and Low-incidence Areas of ESCC

Objective To compare the survival condition and related risk factors of the patients with ESCC between high-incidence area (HIA) and low-incidence area (LIA) of ESCC.

Methods We collected the data of 38741 ESCC patients confirmed by pathology, among which, 23273 cases (60.1%) were from HIA and 15468 cases (39.9%) were from LIA. All patients underwent radical esophagectomy. Chi-square test was used to analyze the differences between groups of the patients with different clinicopathological characteristics, and Kaplan-Meier method was used to draw and Log rank test was used to assess the survival curves of the patients. Cox proportional hazards model was used to analyze the main influencing factors of survival.

Results The proportion of male patients in LIA was higher than that in HIA (P < 0.001). The proportion of patients ≥50 years old in LIA was also higher than that in HIA (P < 0.001). ESCC patients in HIA had obviously better overall survival than patients in LIA (P < 0.001). HIA/LIA, gender, age at diagnosis, tumor location, differentiation, TNM stage and family history were independent factors for the survival of ESCC patients.

Conclusion ESCC patients in HIA have obviously higher overall survival than those in LIA. LIA is an independent risk factor for poor survival of ESCC patients.