Impact of sex on premature mortality for elderly patients with early adenocarcinoma of the esophagus or stomach

Background: In a recent study, it was shown that patients with pT1 adenocarcinoma of the esophagus or stomach have a shorter survival time compared to an age- and gender-matched group from the normal population despite curative therapy. The reasons for the loss of expected life years (YLL) can only be discussed. The aim of the present evaluation is to analyze the influence of the patients' gender on the results. Methods: The data from the aforementioned study was used for this purpose. Results: Of the 214 patients, 112 had pT1 carcinoma of the esophagus and 102 had gastric carcinoma. The male (m):female (f) ratio was significantly (p<0.0001) different between esophageal (m:f=10:1) and gastric (m:f=3:2) tumors. Women (n=48) were significantly older at the time of treatment with a median age of 69.0 (min:42.0, max:84.7) years than male patients (n=166) with a median age of 62.2 (min:18.5, max: 80.7) years (p<0.001). Tumor characteristics, postoperative course, 5-year survival rate and the rate of YLL were not significantly different between men and women. The analysis of the group of older patients (60 years or older) shows a relevant lower loss of expected life years for women compared to male patients. Conclusion: Women are significantly less likely to develop adenocarcinoma of the esophagus or stomach compared to men. Although the average age of onset is significantly higher for women than for men, the prognosis is the same for both groups. In contrast, women in the group of older patients lose no or only a small number of expected years of life (EYL).