Survival Rate and Prognostic Factors of Esophageal Cancer in East Azerbaijan Province, North-west of Iran

  • Mirinezhad, Seyed Kazem (Liver and Gastrointestinal Disease Research Center) ;
  • Somi, Mohammad Hossein (Liver and Gastrointestinal Disease Research Center) ;
  • Jangjoo, Amir Ghasemi (Radiation Oncology Therapy of IMAM REZA (AS) Hospital, Tabriz University of Medical Sciences) ;
  • Seyednezhad, Farshad (Radiation Oncology Therapy of IMAM REZA (AS) Hospital, Tabriz University of Medical Sciences) ;
  • Dastgiri, Saeed (School of Medicine and National Public Health Management Center) ;
  • Mohammadzadeh, Mohammad (Radiation Oncology Therapy of IMAM REZA (AS) Hospital, Tabriz University of Medical Sciences) ;
  • Naseri, Ali Reza (Radiation Oncology Therapy of IMAM REZA (AS) Hospital, Tabriz University of Medical Sciences) ;
  • Nasiri, Behnam (Radiation Oncology Therapy of IMAM REZA (AS) Hospital, Tabriz University of Medical Sciences)
  • Published : 2012.07.31


Background: Esophageal cancer in Iran is the sixth most common cancer and is particularly important in east Azerbaijan. The aim of this study was to calculate survival rates and define prognostic factors in esophageal cancer patients. Methods: In this study, all patients with esophageal cancer registered in the Radiation Therapy Center, during March 2006 to March 2011, were analyzed and followed up for vital status. Data were analyzed using the Kaplan-Meier method and the Cox proportional hazard models. Results: Out of 532 patients, survival information was available for 460, including 205 (44/ 5%) females and 255 (55/4%) males. The mean age was $65.8{\pm}12.2$, ranging from 29 to 90 years at the time of diagnosis. 1-, 3- and 5-year survival rates after diagnosis were 55%, 18% and 12%, respectively, with a median survival time of $13.2{\pm}.7$ (CI 95% =11.8-14.6) months. In the univariate analysis, age (P=0/001), education (P=0/001), smoking status (P= 0/001), surgery (P= 0/001), tumor differentiation (P= 0/003) and tumor stage (P= 0/001) were significant prognostic factors. Tumor morphology, sex, place of residence, tumor histology and tumor location did not show any significant effects on the survival rate. In multivariate analysis, age (P = 0/003), smoking (P= 0/01) and tumor stage (P= 0/001) were significant independent predictors of survival. Conclusion: In summary, prognosis of esophageal cancer in North West of Iran is poor. Therefore, reduction in exposure to risk factors and early detection should be emphasized to improve survival.



  1. Aghcheli K, Haji-min Marjani A, Nasrollahzadeh D, et al (2011). Prognostic factors for esophageal squamous cell carcinoma-a population-based study in Golestan province, Iran, a High Incidence Area. PLoS ONE, 6, 1-7.
  2. Aghajanzadeh M, Rahimi A, Partovian M, Golalizadeh D, Moghaddamnia M (2009). The survival of patients with esophageal cancer after chemoradiation versus surgery and chemoradiation. J Guilan Univers Med Sci, 71, 13-8.
  3. Alidina A, Gaffar A, Hussain F, et al (2004). Survival data and prognostic factors seen in Pakistani patients with esophageal cancer. Ann Oncol, 15, 118-22.
  4. Bashash M, Hislop TG, Shah AM, et al (2011). The prognostic effect of ethnicity for gastric and esophageal cancer: the population-based experience in British Columbia, Canada. BMC Cancer, 11, 164.
  5. Bashash M, Shah A, Hislop G, et al (2008). Incidence and survival for gastric and esophageal cancer diagnosed in British Columbia, 1990 to 1999. Can J Gastroenterol, 22, 143-8.
  6. Courrech Staal EF, van Coevorden F, Cats A, et al (2009). Outcome of low-volume surgery for esophageal cancer in a high-volume referral centre. Ann Surg Oncol, 16, 3219-26.
  7. Gaur P, Sepesi B, Hofstetter WL, et al (2010). Endoscopic esophageal tumor length: a prognostic factor for patients with esophageal cancer. Cancer, 117, 63-9.
  8. Ghadimi M, Rasouli M, Mahmoodi M, Mohammad K (2011). Prognostic factors for the survival of patients with esophageal cancer in Northern Iran. J Res Med Sci, 16, 1261-72.
  9. Hajian-Tilaki KO (2001). Factors affecting the survival of patients with esophageal carcinoma under radiotherapy in the north of Iran. Br J Cancer, 85, 1671-4.
  10. Hussain SK, Lenner P, Sundquist J, Hemminki K (2008). Influence of education level on cancer survival in Sweden. Annals of Oncology, 19, 156-62.
  11. Nomura M, Shitara K, Kodaira T, et al (2012). Prognostic impact of the 6th and 7th American joint committee on cancer tnm staging systems on esophageal cancer patients treated with chemoradiotherapy. Int J Radiation Oncol Biol Phys, 82, 946-52.
  12. Rades D, Lang S, Schild SE, Alberti W (2006). Prognostic value of haemoglobin levels during concurrent radio-chemotherapy in the treatment of oesophageal cancer. Clin Oncol, 18, 139-44.
  13. Samadi F, Babaei M, Yazdanbod A, et al (2007). Survival rate of gastric and esophageal cancers in Ardabil province, North-West of Iran. Arch Iran Med, 10, 32-7.
  14. Shitara K, Matsuo K, Hatooka S, et al (2010). Heavy smoking history interacts with chemoradiotherapy for esophageal cancer prognosis: a retrospective study. Cancer Sci, 101, 1001-6.
  15. Somi M H, Farhang S, Mirinezhad S K, et al (2008). Cancer in East Azerbaijan, Iran: Results of a Population-based Cancer Registry. Asian Pac J Cancer Prev, 9, 327-30.
  16. Sundelof M, Lagergren J, Ye W (2008). Patient demographics and lifestyle factors influencing long-term survival of esophageal cancer and gastric cardiac cancer in a nationwide study in Sweden. Eur J Cancer, 44, 1566-71.
  17. Taziki M, Rajaee S, Behnampour N, Tadrisee M, Mansourian AR (2011). Esophageal cancer: 5-year survival rate at south-east of Caspian sea of northern Iran. J Cancer Res Ther, 7, 135-7.
  18. Verhoef C, van de Weyer R, Schaapveld M, Bastiaannet E, Plukker JT (2007). Better survival in patients with esophageal cancer after surgical treatment in university hospitals: a plea for performance by surgical oncologists. Ann Surg Oncol, 14, 1678-87.
  19. Zafirellis K, Dolan K, Fountoulakis A, et al (2002). Multivariate analysis of clinical, operative and pathologic features of esophageal cancer: who needs adjuvant therapy? Dis Esophagus, 15, 155-9.

Cited by

  1. A Phase II Study on Continuous Infusional Paclitaxel and 5-Fu as First-line Chemotherapy for Patients with Advanced Esophageal Cancer vol.13, pp.11, 2012,
  2. Survival in Patients Treated with Definitive Chemo-Radiotherapy for Non-Metastatic Esophageal Cancer in North-West Iran vol.14, pp.3, 2013,
  3. Prognostic Value of Preoperative Serum CA 242 in Esophageal Squamous Cell Carcinoma Cases vol.14, pp.3, 2013,
  4. Prognostic Value of Subcarinal Lymph Node Metastasis in Patients with Esophageal Squamous Cell Carcinoma vol.14, pp.5, 2013,
  5. Impact of Postoperative Chemoradiotherapy and Chemoradiotherapy Alone for Esophageal Cancer in North-West Iran vol.14, pp.6, 2013,
  6. Epidemiology of Esophageal Cancer in Ardabil Province During 2003-2011 vol.14, pp.7, 2013,
  7. Systematic Analysis of Pemetrexed-based Chemoradiotherapy for Patients with Locally Advanced or Metastatic Esophageal Cancer vol.15, pp.19, 2014,
  8. Impact of Tumor Length on Survival for Patients with Resected Esophageal Cancer vol.15, pp.2, 2014,
  9. Late Stage and Grave Prognosis of Esophageal Cancer in Thailand vol.16, pp.5, 2015,
  10. A comparative study on the efficacy of fast-track surgery in the treatment of esophageal cancer patients combined with metabolic syndrome vol.14, pp.4, 2017,
  11. Evaluating the Correlation Between the Survival Rate of Patients with Esophageal Squamous Cell Carcinoma and Expression of p53 and Cyclin D1 Biomarkers Along with Other Prognostic Factors vol.49, pp.1, 2018,