Epidemiologic and survival analysis for patients with secondary esophageal Cancer: a population-based study and external validation

There is a lack of dedicated studies addressing the epidemiology, prognostic factors, and optimal management strategies for secondary esophageal cancer (SEC). This study sourced data from the SEER database and an independent external cohort. Annual percentage change (APC) was calculated to qualify the incidence trend. Cox regression was employed for survival analysis. A total of 13,792 sec cases from the SEER database and 63 cases from the validation cohort were included in this study. The incidence of SEC increased from 0.95 per 100,000 persons in 2000 to 1.2 per 100,000 in 2008, stabilizing thereafter. Survival analysis identified disease stage, age, and tumor location as significant prognostic factors (All p < .05). A prognostic model incorporating these variables demonstrated robust predictive accuracy across training, testing, and validation cohorts, with a C-index of around 0.73. In terms of treatment, radiotherapy and chemotherapy were associated with improved survival, while no significant benefit for younger patients and those with early-stage or squamous cell carcinoma. There remains a critical need for early detection methods and the implementation of more personalized treatment strategies. The developed prognostic model provides a framework for risk stratification, supporting the optimization of therapeutic decisions and improving patient outcomes.