Abstract
Describe the demographics, clinical status, treatment patterns, HCRU, economic outcomes and survival of patients with esophageal cancer (EC) in Japan. This retrospective observational study included patients with a primary ICD-10 code of EC in ≥2 hospital claims from Jan 1st, 2012 through Dec 31st, 2018 in the Medical Data Vision Co., Ltd (Tokyo, Japan) database of records from >300 hospitals across Japan. The first date of an EC admission was defined as the index date. Patients were followed for a minimum ± 30 days from the index date and were stratified by EC stage and clinical presentation (ie, resectable vs. non-resectable advanced). Key characteristics such as demographics, clinical parameters, medication utilization, HCRU, costs incurred, and survival were tracked for the overall population and stratified cohorts. The included cohort (N=6645) were predominantly male (n=5607, 84.4%) former or current smokers (n=3948, 59.4%) of mean (SD) age 69.2 (9.2) years. At the index date, 20.5% (n=1364) of patients had resectable, 14.8% (n=983) non-resectable advanced and 64.7% (n=4298) unknown clinical presentation; 36.0% had EC of stage 0–2, 35.5% stage 3–4 and 28.5% stage unknown. After the index date, nearly half the patients (n=3241, 48.8%) received first line (1L) chemotherapy with the most common being cisplatin + fluorouracil combination (n=1517, 46.8% of 1L patients) and fluorouracil monotherapy (n=566, 17.5% of 1L patients). The annualized EC-related HCRU costs for inpatient, outpatient and pharmacy was ¥ 731,000 in 2019¥. The average patient follow-up was 19.3 months (95% CI: 2.0 – 58.4) with the majority of patients (n=5178, 77.9%) alive at the end of the observation period. In this cohort of patients with EC, the most common 1L chemotherapies were fluoropyrimidine and platinum-containing combinations. EC-related HCRU costs appear to be a substantial financial burden in Japan.
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