OBJECTIVES

: To identify patients with unresectable/locally advanced or metastatic esophageal cancer in France.

METHODS

: An observational retrospective study was conducted using the French exhaustive National hospital discharge database (PMSI). As there is no specific ICD-10 code for this specific stage, the study considered a stepwise approach algorithm based on expert inputs and combining criteria as ICD-10, surgery codes, treatment duration and stays in palliative care. Adults hospitalized with an ICD-10 code of esophageal cancer (C15 excluding C152) in 2015 and 2016 were included. Patients with a surgery were excluded, except those having a metastasis (C77-C79). Patients considered too weak to receive another treatment were excluded if they had a treatment discontinuation in the 2-month period after the first chemotherapy and/or at least one stay through palliative care. Treatment was defined as chemotherapy (Z511) and treatment lines were defined as (i) First line for the 0-6 months period after patient identification, (ii) Second line for the 6-10 months period and (iii) Third line for the 10 months and over period, in accordance with literature.

RESULTS

: Overall, 19,582 patients with unresectable/locally advanced or metastatic esophageal cancer were identified: a prevalent number of 11,878 patients (6,791 new cases) in 2015 and 13,713 in 2016 (6,520 new cases). Among these patients, 9,799 were considered eligible to receive a treatment, and 4,032 received at least one chemotherapy session during the study period (1^st line: 3,962, 2^nd line: 1,225 and 3^rd line: 351). Patients were aged 65.2±9.6, 64.0±9.3 and 63.7±9.4 respectively for each treatment line and proportion of men was 81.8%, 82.3% and 87.2% respectively.

CONCLUSIONS

: Stepwise algorithm was defined from French hospital discharge database to identify patients with unresectable/locally advanced or metastatic esophageal cancer. Results were aligned with published literature. This will lead to future studies to assess burden of this disease in France.