Prognostic Factors and Survival Outcomes in Esophageal Cancer Patients from North-East India: A Hospital-Based Cohort Study Using Log-Rank Test and Binary Logistic Regression Analysis

Abstract

Background: Esophageal cancer remains one of the most prevalent malignancies in North-East India, accounting for significant morbidity and mortality. The region demonstrates age-adjusted incidence rates substantially higher than other parts of India, with squamous cell carcinoma being the predominant histological type. Understanding prognostic factors and survival outcomes is essential for optimizing therapeutic interventions and patient counseling.
Objective: This study aimed to identify prognostic factors influencing survival outcomes in esophageal cancer patients from North-East India using log-rank test and binary logistic regression analysis.
Methods: A hospital-based retrospective cohort study of 502 esophageal cancer patients was conducted at the State Cancer Institute, Gauhati Medical College, Assam, India, for the period 2019–2021. Survival data were analyzed using the Kaplan-Meier method with log-rank tests to compare survival curves between demographic and clinical variables. Binary logistic regression with logit link function was employed to identify independent predictive factors for mortality.
Results: The study cohort consisted of 502 patients (80.68% aged ≥50 years, 67.3% males) with 271 deaths (54%) recorded during follow-up. Median overall survival was 14 months (95% CI: 11.99–16.01). Log-rank test revealed statistically significant associations with survival for esophagostomy surgery (p<0.001) and chemotherapy (p<0.001). Binary logistic regression identified chemotherapy (p=0.003, OR=1.891) and radiotherapy (p=0.049, OR=0.626) as independent prognostic factors, with chemotherapy conferring increased odds of mortality, whereas radiotherapy demonstrated protective effects.
Conclusions: This study demonstrates that chemotherapy and radiotherapy status constitute independent prognostic factors for esophageal cancer survival in North-East India. The protective effect of radiotherapy and the association with chemotherapy warrant further investigation to optimize multimodal treatment strategies. Socioeconomic status and basic demographic factors did not significantly influence survival outcomes after adjustment for treatment variables.