Oesophageal cancer

Oesophageal cancer is a common type of cancer with a dire prognosis. It is globally the eight most frequent malignancy and the sixth leading cause of death from cancer. The doctoral research described in this thesis has addressed the surgical treatment of oesophageal cancer from a morbidity perspective. It also provides some insight into the enigmatic male predominance of the most rapidly increasing subtype of oesophageal cancer, namely adenocarcinoma. In this work it is shown that postoperative surgical complications decrease health-related quality of life measured 6 months after oesophageal cancer resection. It also shows that surgeon volume is not correlated to the incidence of surgical morbidity, while high-volume surgeons differ substantially in complication rates. Using cancer registries, it is also established that the high male-to-female ratio in oesophageal adenocarcinoma is age-dependent, displaying the highest ratio in the young. Furthermore, using a national survey, it is shown that there is no large difference in the distribution of known risk factors for oesophageal adenocarcinoma between men and women, thus not explaining the male predominance.