Background
Socioeconomic status (SES) impacts outcomes following surgery for various cancers. There are currently no Australian studies that examine the role of socioeconomic disadvantage on outcomes following oesophagectomy for cancer. This study assessed whether SES was associated with short-term perioperative and long-term survival and oncological outcomes following oesophagectomy across three tertiary oesophageal cancer centres in Australia.
Methods
A retrospective cohort study was performed of all patients who underwent oesophagectomy for cancer across three Australian centres. Patients were stratified into SES groups using the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD). Outcomes measured included perioperative complication rates, overall survival, and disease-free survival.
Results
462 patients were analysed, with 205 in the lower SES and 257 in the higher SES groups. Compared to those with higher SES, the lower SES group presented with more advanced oesophageal cancer stage, with higher rate of T3 disease (52.6% vs. 42.7%, p=0.038) and N2 disease (19.6% vs. 10.5%, p=0.006), and had a higher rate of readmission within 30 days (11.2% vs. 5.4%, p=0.023). There was no difference in overall survival or disease-free survival between the lower SES and higher SES groups.
Conclusion
Disparities exist in certain outcomes following oesophagectomy for cancer in an Australian cohort. Socioeconomic status was associated with more advanced stage at presentation and increased risk of readmission following oesophagectomy.