Impact of Occupation on Survival of Esophageal Squamous Cell Carcinoma Patients Following Esophagectomy: A Long-Term Survival Analysis

Background Esophageal cancer (EC), particularly esophageal squamous cell carcinoma (ESCC), is a major global health issue with high incidence and mortality rates in Asia. This study examines the impact of occupational background on the long-term survival of ESCC patients following esophagectomy. Methods Data were obtained from the Sichuan Cancer Hospital & Institute Esophageal Cancer Case Management Database, focusing on patients with ESCC who underwent esophagectomy between 2010 and 2017. Patients were classified into four occupational groups: Farmer, Civil Servant, Teacher, and Factory Worker. The primary outcome measured was overall survival (OS), which was analyzed using Kaplan–Meier survival curves, Cox proportional hazards models, and restricted mean survival time (RMST). To account for potential confounding factors, propensity score matching (PSM) was employed. Results Among the cohort, 67.5% were Farmers, 9.0% Civil Servants, 1.9% Teachers, and 21.6% Factory Workers. The median follow-up was 72.2 months, with a median OS of 49.8 months. Factory Workers had the highest one-year survival rate at 91%. Significant survival differences were observed between Farmers and Civil Servants (HR: 1.291; P = 0.027), which persisted after PSM (HR: 1.376; P = 0.047). Civil Servants, with more advanced disease, had the lowest crude RMST, aligning more closely with other groups after adjustment. Conclusion The results revealed that ESCC patients categorized as Civil Servants exhibited a poorer prognosis compared to those classified as Farmers.