How do men and women respond to treatment for esophageal cancer differently?

Men and women may respond to treatment for esophageal cancer differently, according to a Mayo Clinic study. Researchers determined that women with locally advanced esophageal cancer that is treated with chemotherapy and radiation therapy before surgery are more likely to have a favorable response to the treatment than men, and women are less likely to experience cancer recurrence. 

Researchers analyzed data from women with locally advanced esophageal cancer who underwent chemotherapy and radiation prior to surgery between 1990 and 2013 at all three Mayo Clinic sites (Rochester, MN, Scottsdale, AZ, and Jacksonville, FL). A comparison group of men were identified based on matching criteria such as age, pretreatment clinical stage, histologic type and surgical era. Only people staged preoperatively with computed tomographic (CT) scans and endoscopic ultrasonography were included.  
The final cohort included 366 people (145 women, 221 men). The median age for the women was 64 years and 61 years for the men. They had two primary types of esophageal cancer -- adenocarcinoma (cancer originating in gland cells/lower part of the esophagus), found in 105 (72%) women and 192 (87%) men, and squamous cell carcinoma (cancer starting in cells that line the esophagus), diagnosed in 40 (28%) women and 29 (13%) men.  
The study showed that either complete or near complete pathologic response occurred in 84 women (58%) vs. 103 men (47%). There also was a trend toward superior five-year survival for women vs. men (52.1% vs. 44.0%), but this did not reach statistical significance.

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