Gender differences in clinicopathologic features and outcomes of esophageal cancer patients treated surgically

Background We investigated the clinicopathologic features and long-term outcomes after surgery of Japanese women with esophageal cancer in comparison to those of men. Methods A total of 136 patients with esophageal cancer were surgically treated between 1996 and 2008 (22 [16.2%] women and 114 men). Gender differences in these patients were retrospectively investigated. Results Women undergoing esophagectomy for esophageal cancer showed lower frequencies of cigarette smoking (p < 0.0001) and alcohol consumption (p < 0.0001) compared to men. Preoperative co-morbidities in women were fewer than those in men (p < 0.001). Regarding the clinicopathologic features of esophageal cancer, women frequently had superficial cancer and no node metastasis (p < 0.05). Women had lower-level morbidity after surgery (p < 0.05), but no mortality after surgery was observed in men or women. Although there was no difference in other causes of death after surgery between them, recurrence/metastasis after surgery was more frequent in men than women (p < 0.05). The 5-year survival rate after surgery was higher in women than men (p < 0.05), but gender difference was not an independent prognostic factor. Conclusions Significant gender differences in patients with esophagectomy were observed regarding the preoperative condition, clinicopathologic features, postoperative condition, and long-term outcome after surgery. It was suggested that the more favorable outcome of women with esophageal cancer was associated with their earlier stages of esophageal cancer.