Younger women with esophageal carcinoma exhibit improved prognosis after esophagectomy: a single-center, high-volume cohort study

The prognostic significance of sex and age-sex in patients with esophageal carcinoma (EC) remains unclear. This study aimed to clarify whether the sex or age-sex factor influences the prognosis of patients with EC after esophagectomy. The data were sourced from an original database, which includes data on patients with EC who had undergone esophagectomy between 2012 and 2016 at a high-volume cancer center. The cut-off age in our study was 55 years. Based on age and sex, the patients were categorized into the following four groups: Group A, comprising women aged ˂ 55 years; Group B, women aged ≥ 55 years, Group C, men aged ˂ 55 years; and Group D, men aged ≥ 55 years. Cox regression analysis was used for multivariate analysis. Propensity score matching (PSM) was used to adjust for the confounding factors. A total of 1576 patients was included. The 5-year OS rates for groups A, B, C, and D were 59.0%, 53.2%, 42.4%, and 45.4%, respectively, with statistically significant differences between them (P < 0.001). The multivariable Cox regression analysis revealed that age-sex groups, adjuvant therapy, and pTNM stage were independent prognostic factors. Following PSM, the results demonstrated that younger women with EC had a significantly better prognosis than did patients in other age and sex cohorts (hazard ratio [HR]: 0.368, 95% confidence interval [CI]: 0.203–0.666). Compared with other patients, younger women with EC had a significantly better prognosis after esophagectomy.