The epidemiological trend of esophageal cancer in Mumbai, India over the past two decades.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16095-e16095
Author(s):  
Anbarasan Sekar ◽  
Akhil Rajendra ◽  
Vanita Noronha ◽  
Smruti Mokal ◽  
Vijay Maruti Patil ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Alcohol Use ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Female Ratio ◽  
Histologic Subtype ◽  
The Past ◽  
Increased Risk ◽  
History Of

e16095 Background: There has been a definite histopathological shift in esophageal cancer in the West over the past few decades, with adenocarcinoma overtaking squamous cell carcinoma as the commonest type. Asian countries with a high human development index like China have also reported an increased incidence of esophageal adenocarcinoma. Data on the epidemiology of esophageal cancer in India are limited. Methods: We retrospectively evaluated the data of all patients with histologically proven esophageal cancer at Tata Memorial Hospital, from 2003 to 2018. We excluded non-squamous and non-adenocarcinoma histologies. Results: Of a total of 7,874 patients with esophageal cancer, 5,092 (64.7%) were men, for a male to female ratio of 2.5:1. The median age was 57 years (IQR, 50-65); 4,465 (56.7%) were below 60 years old. Of the 4912 patients in whom a history of tobacco or alcohol use had been elicited, there were 1,360 (27.7%) patients with no history of substance use. The site of the primary was the upper third in 906 (12.8%), middle third esophagus in 2,942 (41.5%), lower third in 2,331 (32.8%) and gastroesophageal junction in 917 (12.9%) patients. The predominant histology was squamous cell carcinoma in 6,413 (81.4%) patients and adenocarcinoma in 1461 (18.6%). There was no change in the histologic pattern over the period of the study; squamous cell carcinoma constituted 78.5% of the cases in 2003, and 85.5% in 2018; Chi square test for the year wise trend in histologic patterns was not significant, p=0.143. Evaluation of the histologic subtype according to sex revealed that in the male patients, there were 3890 (76.4%) squamous and 1202 (23.6%) adenocarcinoma cases, while in female patients, there were 2523 (90.7%) squamous and 259 (9.3%) adenocarcinoma cases. On a uni variate analysis, male sex (p<0.001), a history of tobacco or alcohol use (p<0.001), and the presence of comorbidity (p<0.007) were associated with an increased risk of squamous cell carcinoma. Multivariate analysis by logistic regression model revealed that female sex and use of tobacco or alcohol were positively associated with squamous cell carcinoma, while the presence of comorbities and primary in lower esophagus/GEJ were positively associated with adenocarcinoma. Conclusions: Squamous cell carcinoma continues to be the commonest esophageal cancer histologic subtype in over 80% Indian patients. The mid esophagus is the most common site (42%). There is no evidence of an epidemiological shift or an increase in the occurrence of adenocarcinoma or of lower esophageal/GEJ malignancy over the past two decades.

scholarly journals Concurrent Squamous Cell Carcinoma and Chronic Lymphocytic Leukemia Presenting as an Enlarging Neck Mass

2019 ◽  
Vol 7 ◽  
pp. 232470961984290
Author(s):  
Prabhjot Bhinder ◽  
Michael Chahin ◽  
Lara Zuberi
Keyword(s):  
Squamous Cell Carcinoma ◽  
Chronic Lymphocytic Leukemia ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Neck Mass ◽  
Lymphocytic Leukemia ◽  
Secondary Malignancies ◽  
Increased Risk ◽  
History Of ◽  
Tonsillar Squamous Cell Carcinoma

Chronic lymphocytic leukemia (CLL) patients are at an increased risk for developing more aggressive lymphomas via Richter’s transformation and of developing secondary malignancies. Despite the known association for secondary cancers, oropharyngeal cancers occur rarely. We present a case of a woman with a history of CLL who presented to our facility via transfer for impending airway compromise. Her initial workup was consistent with CLL; however, biopsies were taken of the neck mass because of its aggressive nature. She was treated with rituximab with good response. Final pathology showed evidence of CLL and tonsillar squamous cell carcinoma (SCC). Direct laryngoscopy and further biopsies yielded a diagnosis of unresectable oropharyngeal SCC. She was to be treated with chemotherapy and radiation for her SCC while holding treatment for CLL. This case demonstrates a rare and unexpected concurrent diagnosis.

Voriconazole Exposure and The Risk Of Cutaneous Squamous Cell Carcinoma In Allogeneic Hematopoietic Stem Cell Transplant Patients

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 916-916
Author(s):  
Shahrukh K Hashmi ◽  
Daniel Wojenski ◽  
Gabriel Bartoo ◽  
Julianna A. Merten ◽  
Ross Dierkhising ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Risk Factor ◽  
Stem Cell ◽  
Cell Carcinoma ◽  
Hematopoietic Stem Cell ◽  
Squamous Cell ◽  
Hematopoietic Stem ◽  
Increased Risk ◽  
History Of ◽  
Over Time

Abstract Background Voriconazole is a common antifungal medication used in allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients. In solid organ transplantation, multiple studies have associated the use of voriconazole with the development of squamous cell carcinoma (SCC) post-transplant, but its association with SCC in allo-HSCT patients is unknown. We sought to determine this association. Methods After IRB approval, Mayo Clinic’s transplant database (2007-2012) was accessed and electronic charts of allo-HSCT patients were retrospectively reviewed. Voriconazole exposure was defined as exposure to voriconazole at any time during treatment of primary disease, prior to or following HSCT. Cumulative voriconazole exposure was defined as total days of voriconazole use following HSCT; days were not required to be consecutive. Two time-dependent voriconazole exposure variables were defined: (1) history of voriconazole exposure (yes/no) over time, and (2) cumulative days on voriconazole over time. Results 404 patients underwent allo-HSCT during this timeframe, and 381 patients (table 1) were included in the final analysis. 23 patients were excluded (8 patients received multiple transplants, 9 patients were treated under pediatric protocols, 6 patients lacked research consent). 312/381 received voriconazole; other antifungal therapy included fluconazole (n=40), posaconazole (n=23), anidulafungin (n=1), and caspofungin (n=5). Median duration of cumulative days of voriconazole was 214 (range 2 -1553). SCC developed in 26/312 exposed to voriconazole and in 1/69 who received alternative antifungals. Cumulative incidence of SCC at 1 year was 3%, 2 years was 8%, 3 years was 13%, 4 years was 14%, and at 5 years was 19% (figure 1). Cumulative days of voriconazole use was found to be a risk factor for the development of SCC, and this relationship persisted in a multivariate model using previously identified risk factors (gender, age at transplant, TBI conditioning regimen, skin cancer pre-HSCT, chronic GVHD) as covariates (HR 1.859 for each 180 days of use, p<0.001). History of prior voriconazole exposure was not associated with an increased risk of SCC after covariate adjustment (HR 2.436, p=0.2369). Conclusion This is the first study to establish cumulative days of voriconazole use as a risk factor for SCC development following allo-HSCT, and may help guide appropriate antifungal prophylaxis in this patient population which is already at an increased risk of developing skin cancers. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Pattern of esophageal cancer in tertiary care hospital in North India: a clinicopathological study

2017 ◽  
Vol 5 (4) ◽  
pp. 1405
Author(s):  
Vishal Gupta ◽  
Subash Bhardwaj ◽  
Opinder Kumar Bhagat
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tertiary Care ◽  
Undifferentiated Carcinoma ◽  
North India ◽  
Histopathological Analysis ◽  
Care Hospital ◽  
Female Ratio

Background: Esophageal cancer is one of the deadliest and eighth most common cancer worldwide. It is the sixth most common cause of cancer related deaths with developing nations making up more than 80% of total cases and deaths. The purpose of this study was to assess the histopathological pattern of esophageal cancer in our region.Methods: In our centre, we analyzed 101 cases of endoscopic esophageal biopsy proven cases of esophageal cancer from January 2014 to June 2016. In most of these cases, dysphagia was the commonest indication of esophageal endoscopy.Results: 65 cases (64.4%) were males and 36 cases (35.6%) were females. Most of the patients were in the age group of 41-60 years. The histopathological analysis revealed squamous cell carcinoma as the most common esophageal cancer (n=61, 60.4%) followed by adenocarcinoma (n=38, 37.6%) and 02 cases of undifferentiated carcinoma (2%).Conclusions: Esophageal cancer is one of the commonest digestive tract malignancy in India. The males are affected more than the females with male to female ratio of 1.8:1. The maximum number of cases being seen in fifth and sixth decade of life. The squamous cell carcinoma is the most common esophageal cancer seen, with middle esophagus being the commonest site. However, the number of cases of adenocarcinoma are on rise.

scholarly journals Clinical, epidemiological, and diagnostic characteristics of esophageal carcinoma in a Pakistani population

2021 ◽  
Vol 41 (2) ◽  
pp. 91-100
Author(s):  
Muhammad Sohaib Asghar ◽  
Noman Ahmed Khan ◽  
Syed Jawad Haider Kazmi ◽  
Maira Hassan ◽  
Uzma Rasheed ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Esophageal Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Care Hospital ◽  
Female Ratio ◽  
Luminal Narrowing ◽  
Male To Female

BACKGROUND: Esophageal cancer ranks eighth among the most prevalent cancers globally and is the sixth leading cause of mortality from malignancy worldwide; it is the 7th most prevalent malignancy in males and the 6th most prevalent malignancy in females. In Pakistan, the incidence is 4.1 per 100 000 with the province of Baluchistan having the greatest incidence. OBJECTIVE: Report trends and characteristics of esophageal cancer in Pakistan over the past 10 years. DESIGN: Cross-sectional, retrospective review of medical records. SETTING: Tertiary care hospital. PATIENTS AND METHODS: The study included all patients admitted with a diagnosis of esophageal carcinoma with a mass lesion or luminal narrowing. The records were for the period from January 2011 to September 2020. MAIN OUTCOME MEASURES: Gender, histopathological types/differentiation along with clinical/laboratory findings. SAMPLE SIZE: 1009 with a mean (standard deviation) age of 49.3 (14.2) and a median (interquartile range of 50 (22) years (443 males and 566 females with age of 51.0 [20] years and 47.9 [23.8] years, respectively). The male-to-female ratio was 1:1.2. RESULTS: Most patients (82.7%) had squamous cell carcinomas with a male-to-female ratio of 1:2; the remainder had adenocarcinomas with a male-to-female ratio of 4:1 ( P <.001). Dysphagia, weight loss, and vomiting were the most prevalent symptoms. More adenocarcinoma masses were located distally compared with squamous cell carcinomas ( P =.030), lesions were most likely to be ulcerated ( P =.910). Luminal narrowing was slightly more frequent in squamous cell carcinoma ( P =.215), thickening was more prominently circumferential in the adenocarcinomas. In squamous cell carcinoma, the most common variant was moderately differentiated while moderate to poorly differentiated variants were more common in adenocarcinoma. In the survival analysis, squamous cell carcinoma ( P =.014 vs adenocarcinoma), particularly the well-differentiated type ( P =.018 vs other variants), projected a better prognosis. CONCLUSION: Our study reports the most recent trends of esophageal carcinoma in this region. LIMITATIONS: Lack of metastatic workup, TNM staging, and mode of treatment, along with the overlapping pattern of histological variants. CONFLICT OF INTEREST: None.

Incidence of brain metastasis from esophageal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 165-165
Author(s):  
Jonathan Ben Ashman ◽  
Gabrielle Welch ◽  
Naresh P. Patel ◽  
Dawn E. Jaroszewski ◽  
David Fleischer ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Cell Carcinoma ◽  
Surgical Resection ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Stage Iv ◽  
Distant Metastases ◽  
Primary Diagnosis ◽  
Histologic Subtype

165 Background: Distant metastases are common in primary esophageal cancer, but data conflict regarding the rates of brain metastases (BM) ranging from 0% to 13%. We sought to investigate whether the incidence of BM from esophageal malignancies is increasing in the modern era. Methods: After IRB approval, a single institution retrospective review identified 583 patients (pts) treated between 1/1997 and 1/2016 for stage I-IV cancer of the esophagus/esophagogastric junction with at least 3 months follow-up. Data collected included demographic information, primary diagnosis date and staging, histologic subtype, treatment regimens for primary and BM, date of BM diagnosis, status of neurologic symptoms and extracranial disease at BM diagnosis, and date of death. Data were analyzed by Fischer’s exact test and Kaplan-Meier analysis. Results: The overall cohort was comprised of 495 pts (85%) with adenocarcinoma and 82 pts (14%) with squamous cell carcinoma. 492 pts (84%) were male; the median age was 68 years (range 26-90). BM were identified in 22 pts (3.8%) with a median latency of 11 months from the primary diagnosis. Of the pts with BM, the primary histology was adenocarcinoma in 21 pts and squamous cell carcinoma in 1 pt ( P = 0.3). BM developed in 12 pts who were initially treated for locally advanced disease and in 10 pts who presented with distant metastases. Diagnosis of BM was at the time of initial presentation in 4 of these 10 stage IV pts. A solitary BM was identified in 9 pts. Initial treatments of BM were surgical resection followed by stereotactic radiosurgery (SRS; n = 5); surgical resection followed by whole brain radiotherapy (WBRT; n = 1); WBRT alone (n = 13); SRS alone (n = 3). Overall survival (OS) following diagnosis of BM was 18% at 1 year with a median of 4 months. OS was superior for pts who had surgical resection as initial treatment of BM compared to pts treated with WBRT or SRS alone (1-year OS 67 vs. 0%; median OS 13.5 vs. 3 months; P = 0.003). Conclusions: The incidence of BM is low in esophageal cancer with no statistically significant increased rate of BM developing in patients with adenocarcinoma compared with squamous cell carcinoma. Outcomes were poor overall for pts who developed BM, but pts who were appropriate for neurosurgical resection had improved survival.

scholarly journals Three Fatal Cases of Squamous Cell Carcinoma Arising in Chronic Perineal Hidradenitis Suppurativa

2007 ◽  
Vol 89 (7) ◽  
pp. 709-712 ◽  
Author(s):  
Gael M Maclean ◽  
David J Coleman
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Hidradenitis Suppurativa ◽  
Squamous Carcinoma ◽  
Apocrine Glands ◽  
Medline Search ◽  
The Past ◽  
History Of ◽  
Malignant Condition

INTRODUCTION Hidradenitis suppurativa (HS) is a chronic, inflammatory and suppurative disorder of skin bearing apocrine glands. The most severe complication is squamous cell carcinoma (SCC) and we here present three cases, all of which proved fatal, and review the past 40 years of published cases. PATIENTS AND METHODS Three advanced cases of SCC arising in chronic HS have been referred for reconstructive surgery over the past 8 years. Another 28 cases published over the past 40 years were identified using a Medline search (search items in combination: hidradenitis, squamous, carcinoma). RESULTS The male:female ratio was 4:1, most (61%) were perineal or buttock. We found no reports of SCC arising in axillary disease. The symptomatic history of HS prior to SCC diagnosis ranged from 3–50 years with a mean of 25 years. Age at diagnosis of SCC ranged from 27–71 years, and 15 patients (48%) died within 2 years of SCC diagnosis. CONCLUSIONS We advocate that hidradenitis suppurativa arising in extra-axillary sites is a pre-malignant condition, and should not be treated conservatively; curative resection is the mainstay of management.

scholarly journals Predicting Individual Survival after Curative Esophagectomy for Squamous Cell Carcinoma of Esophageal

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Zhiyong Zhao ◽  
Xiaolong Huang ◽  
Ting Gu ◽  
Zhu Chen ◽  
Limin Gan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Predictive Accuracy ◽  
Disease Free Survival ◽  
Chronic Obstructive ◽  
Postoperative Sepsis ◽  
T Stage ◽  
History Of

Background. Esophageal cancer is one of the leading causes of cancer-related death worldwide. Despite the significant progress in the overall treatment of esophageal cancer in recent years, the prognosis for patients who require surgery remains poor. Methods. The present study investigated the clinicopathological features of 503 patients who underwent radical esophagectomy at Huashan Hospital of Fudan University between January 2005 and January 2015. Nomograms that predicted the esophageal squamous cell carcinoma (ESCC) survival rates were established using the Cox proportional hazard regression model. Discrimination and calibration, which were calculated after bootstrapping, were used as a measure of accuracy. Results. Multivariate analyses were used to select five independent prognostic variables and build the nomogram. These variables were pathological T stage, pathological N factor, rate of positive LNs, history of chronic obstructive pulmonary disease (COPD) and postoperative sepsis. The nomogram was built to predict the rates for overall survival (OS) and disease-free survival (DFS). The concordance index for the nomogram prediction for OS and DFS was 0.720 and 0.707, respectively. Compared to the conventional TNM staging system, the nomogram had better predictive accuracy for survival (OS 0.720 vs. 0.672, P < 0.001 ; DFS 0.707 vs. 0.667; P < 0.001 ). Conclusions. The present study incorporated pathological T stage, pathological N factor, rate of positive LNs, history of COPD, and postoperative sepsis into a nomogram to predict the OS and DFS of ESCC patients. This practical system may help clinicians in both decision-making and clinical study design. The assessment of lung function for patients with COPD preoperative, and the control of disease progression are needed. Furthermore, the postoperative infection of patients should be controlled. Further studies may help to extend the validation of this method and improve the model through parameter optimization.

Matched-Pair Analysis of Survival of Never Smokers and Ever Smokers With Squamous Cell Carcinoma of the Head and Neck

2004 ◽  
Vol 22 (19) ◽  
pp. 3981-3988 ◽  
Author(s):  
Kristen B. Pytynia ◽  
Jonathan R. Grant ◽  
Carol J. Etzel ◽  
Dianna B. Roberts ◽  
Qingyi Wei ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Alcohol Use ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
History Of ◽  
Never Smokers ◽  
Pair Analysis

Purpose To compare survival rates between patients with squamous cell carcinoma of the head and neck (SCCHN) without a history of smoking (never smokers) and those with a current or previous history of smoking (ever smokers). Patients and Methods Fifty never smokers with newly diagnosed SCCHN were matched to 50 ever smokers according to sex, age, tumor site, overall stage, nodal stage, and treatment. Survival analysis was performed using Kaplan-Meier estimates. Matched-pair survival was compared using the Cox proportional hazards model. Results The never smokers had a greater overall survival (P = .020), disease-specific survival (P = .022), and recurrence-free survival (P = .016). Furthermore, matched-pair analysis demonstrated smoking was associated with a significant increase in risk of overall death (relative risk [RR] = 3.50; 95% CI, 1.14 to 10.77; P = .029), risk of death owing to disease (RR = 3.98; 95% CI, 1.11 to 14.33; P = .034), and risk of disease recurrence (RR = 3.29; 95% CI, 1.18 to 9.14; P = .023). Smoking was associated with three-fold increases in risk for overall death, death owing to disease, and recurrence after adjustment for cancer-associated symptom severity and alcohol use, but the 95% CI for these adjusted risk estimates each included the null. Conclusion Survival differed significantly between never smokers and ever smokers with SCCHN. These results are not substantively explained by differences in cancer-associated symptoms or alcohol use, but the CIs are wide and some imprecision remains. Regardless, possible fundamental differences in SCCHN between ever smokers and never smokers may exist, and further molecular characterization of these tumors is needed to determine whether biologic differences needing targeted therapies exist.

scholarly journals Pathology and pathobiology of the oesophageal carcinoma

2010 ◽  
Vol 57 (2) ◽  
pp. 15-26 ◽  
Author(s):  
M. Micev ◽  
M. Cosic-Micev
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Oesophageal Carcinoma ◽  
Low Grade ◽  
Sentinel Node Concept ◽  
Increased Risk ◽  
Resection Margin Status ◽  
History Of

Carcinoma of the oesophagus including carcinoma of gastro-oesophageal junction are rapidly increasing in incidence. During recent years there have been changes in the knowledge surrounding biology of the disease progression. Identification of dysplasia in mucosal biopsies is the most reliable pathologic indicator of an increased risk of development of squamous cell carcinoma and passes through the sequence of chronic esophagitis, low-grade and high-grade dysplasia and invasive carcinoma. Although Barrett's esophagus is a precursor to esophageal adenocarcinoma and have a well described sequence of carcinogenesis: the Barrett's metaplasia-dysplasia-adenocarcinoma sequence, not all patients with this disorder require intensive surveillance. The natural history of dysplasia is poorly understood, particularly in low-risk regions, and prospective follow-up studies are needed. Adjunctive methods to improve reproducibility, such as immunostaining for alpha-methylacyl-coenzyme A racemase (AMACR), show promise, but require confirmation in larger studies. In addition, several controversial methods such as detection of p16, p53, and DNA content abnormalities may help identify patients at particularly high risk for progression to cancer, but these techniques are not yet widely available for routine clinical application. More studies are needed to define other early nonmorphologic biomarkers for risk of squamous cell carcinoma. Recent evidence regarding the importance of several histopathologically derived prognostic factors, such as circumferential resection margin status and lymph node metastases are evaluated, including lymph node micrometastases and the sentinel node concept. With the rising use of multimodal treatments for oesophageal cancer it is important that the response of the tumour to this therapy can be carefully documented by histopathology.

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