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

Author(s):  
Vishal Gupta ◽  
Subash Bhardwaj ◽  
Opinder Kumar Bhagat

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.

2021 ◽  
Vol 41 (2) ◽  
pp. 91-100
Author(s):  
Muhammad Sohaib Asghar ◽  
Noman Ahmed Khan ◽  
Syed Jawad Haider Kazmi ◽  
Maira Hassan ◽  
Uzma Rasheed ◽  
...  

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.


2021 ◽  
Vol 14 (4) ◽  
pp. 161-165
Author(s):  
Zoya Sheikh ◽  
Ghulam Haider ◽  
Khalil Ahmed ◽  
Dr. Bhunisha

Background: Around the globe, carcinoma of the esophagus is the eighth most prevalent cancer with an incidence of 456,000 cases per year and is the sixth cause of cancer mortality. There are two major histological subtypes of carcinoma of the esophagus, esophageal squamous cell carcinoma and adenocarcinoma. The aim of the current study is to evaluate the frequency of different histopathological types of esophageal cancer in patients presenting at the tertiary care hospital of Karachi. Patients and methods: It was a cross-sectional study conducted at the Department of Clinical Oncology, Jinnah Postgraduate Medical Center, Karachi from March 2017 till March 2019. Two hundred and one histologically proven cases of esophageal cancer of in patients of either gender and between 15-80 years of age were included. Patients were interviewed and data regarding age, gender, education, marital status, employment status, addictions like cigarette or huqqa smoking, consumption of pan, betel nut, naswar, or gutka were recorded. Endoscopy and histology and computed tomography scan were performed. Stage, site, grade and type of tumor were noted. SPSS version 23 was used to analyze data. Mean and SD were calculated for quantitative variables. Frequency and percentage were calculated for qualitative variables. A Chi-square test was used to assess the significance between age and gender with type of EC. A p-value≤0.05 was taken as significant. Results: Mean age of the patients was 47.84. The majority of the patients had stage 2 of cancer (42.8%) and lower tumor site (62.2%) Squamous cell carcinoma was the most common histopathological type in 137 patients out of 201 (68%). The age, gender, smoking, consumption of pan, grade, site, and stage of the tumor showed a statistically significant difference when compared with esophageal squamous cell carcinoma and esophageal adenocarcinoma. Conclusion: The burden of esophageal squamous cell carcinoma is dramatically increasing in the Pakistani population and squamous cell carcinoma was the most common histopathological type.


2015 ◽  
Vol 47 (1-2) ◽  
pp. 3-6 ◽  
Author(s):  
Sheikh Shahidur Rahman ◽  
Mrinal Kanti Sarker ◽  
Md Haider Ali Khan ◽  
Sushanta Shekhar Biswas ◽  
Moni Mohan Saha

Oral cancer is one of the most common cancer and constitute a major public health problem. It is estimated that more than 90% of all oral neoplasms are oral squamous cell carcinoma. The purpose of the study was to evaluate the clinical profile of patients with oral squamous cell carcinoma for gender, age, education, occupation, personal habits, site of lesion and histological grading. Two hundred and sixteen confirmed cases of oral squarnous cell carcinoma were included in this study. It was conducted over a period of two years from July 2009 to June 2011 in the department of Dental Surgery of Khulna Medical College Hospital. Male female ratio was 1.5: 1. Mean age was 50.46 years. Correlation between two variables ie. level of education and histomorphological pattern of the lesion were found to be statistically nonsignificant (P>0.05). The commonest age of presentation was in the fifth decade of life. Most of the cases reported at advance stages of the disease which often leads to delay in the management. Majority of patients (70.73%) presented with well differentiated squamous cell carcinoma. Tobacco chewing was the major cause for the development of oral carcinoma DOI: http://dx.doi.org/10.3329/bmjk.v47i1-2.22554 Bang Med J (Khulna) 2014; 47 : 3-6


2021 ◽  
Vol 11 (7) ◽  
pp. 111-118
Author(s):  
Diptajit Paul ◽  
Pawan Kumar ◽  
Anil Kumar Dhull

Introduction: Esophageal carcinoma, one of the common malignancies, generally presented in advanced stage makes these neoplasms less curable and highly lethal. Having such poor prognosis, it is significant to understand various patient and tumor facts related to treatment outcome of esophageal cancer, which varies regions wise. The present retrospective study also seeks to focus on current description of patterns and trends of tumors in esophageal cancer patients attended in a tertiary care hospital in a northern state of India and their treatment outcome. Materials and Methods: Records of esophageal carcinoma patients over a period of 3-years were reviewed retrospectively. These records were analysed for incidence, demographic pattern, different treatment modalities and their response evaluation. Results: A total 439-patients of esophageal carcinoma were identified. The median age at presentation was 47-years and males slightly outnumbered females. Among all the tumors, lower thoracic esophagus involvement was most predominant and most common presentation was dysphagia. Squamous cell carcinoma constituted the predominant histopathological type. Majority of patients presented in advanced stage and treated with combined modalities approach of radiation therapy, chemotherapy and surgery. Overall average survival was 13-months. Clinically, the response at last follow-up was CR in 19%, PR and PD in 33% each. Conclusion: Despite its high prevalence in north India and poor survival rate, less initiative has been taken to increase awareness in preventing these cancers. Understandings of socio-demographic patterns and tumor characteristics may improve treatment outcome in these patients and improve quality of life. Further studies are needed in different regions of India, to get more treatment options which may convert the current scenario of palliative intent in to radical one in patients of esophageal carcinoma. Key words: Esophageal carcinoma, retrospective study, socio-demographic profile, dysphagia, squamous cell carcinoma.


Author(s):  
Gurbax Singh ◽  
Jasmine Kaur ◽  
Jai Lal Davessar ◽  
Sumit Prinja

<p><strong>Background:</strong> Head and neck cancer is a deadly disease that has emerged as major health problem. It constitutes one of the commonest cancers in India. Use of smokeless tobacco (pan masala, zarda etc.,) is on the increase in North India and is responsible for the majority of these tumours. The aim of this study is to evaluate demographic profile of patients with squamous cell carcinoma of head and neck cancer and to assess the most common sub-site involved among these patients.</p><p class="abstract"><strong>Methods:</strong> Histologically confirmed patients with squamous cell carcinoma of head and neck were included in study. Retrospective study from 1st January 2011-31st December 2015 was conducted. Records from OPD based register of ENT Department of Guru Gobind Singh Medical College and Hospital was used. Data was statistically analyzed.  </p><p class="abstract"><strong>Results:</strong> Among 1,052 patients, 74.4% were males and 25.6% were females. The male to female ratio was found out to be 3:1. Tongue was the most common sub-site involved whereas the retromolar trigone was least common site involved.</p><p><strong>Conclusions:</strong> The squamous cell carcinomas are the most common head and neck cancer. The carcinomas develop in the upper aero digestive tract after exposure to various carcinogens. </p>


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16095-e16095
Author(s):  
Anbarasan Sekar ◽  
Akhil Rajendra ◽  
Vanita Noronha ◽  
Smruti Mokal ◽  
Vijay Maruti Patil ◽  
...  

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.


2020 ◽  
Vol 27 (05) ◽  
pp. 939-943
Author(s):  
Sameera Asif ◽  
Summera Kanwal ◽  
Tahera Ayub ◽  
Zafar Abbas ◽  
Batool Vazir ◽  
...  

Objectives: Oral Squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral cavity. The study was done with the aim to determine the clinical pattern of OSCC seen in tertiary care hospital of Karachi, Pakistan. The frequency of neck metastasis in different staging of squamous cell carcinoma was also recorded. Study Design: Retrospective study. Setting: Department of Oral & Maxillofacial Surgery Liaquat College of Medicine and Dentistry. Period: June 2013- July 2016. Material & Methods: It included 35 males and 25 females which presented with different sites and stage of squamous cell carcinoma. Clinically patients were staged as stage I, stage II, stage III and stage IV and comprised of 3, 8, 30 & 19 patients respectively. Patients presented with cancer of buccal mucosa (31 patients), retromolar region (12 patients), maxillary alveolus (8 patients), tongue (2 patients), floor of mouth (4 patients) & lip (3 patients). Right side was most common, 48 patients as compare to left side, 12 patients while lip cancers was in upper lip in all patients including commissure. Results: Total 60 patients were included in the study with the male to female ratio of 1.4:1. No significant association was seen between age and gender of the patient (p-value 0.933). Majority of patients were male involving buccal mucosa (51.67%) as the most frequently involved site followed by retromolar area (20%) and tongue (13.3%). Mean age of patients included in the study was 50.87 ± 5.53. Conclusion: Most of the cases of OSCC were seen in older patients with increased number of cases involving buccal mucosa as their primary site. Majority of the tumors were classified as stage III followed by Stage IV, Stage II and stage 1 respectively.


Author(s):  
Ritu Bhat ◽  
Sachin Kolte

Background: Wide range of vulval lesions have been described with similar modes of presentation. Benign and inflammatory lesions form the major chunk. Squamous cell carcinoma is the most reported malignant entity. Aim was to review the vulval lesions received in our departmentMethods: We studied the data from the archives of the Department of Pathology for a period of 5 years from January 2014 to December 2018 for vulval biopsies and specimens sent for histopathological examination. The final diagnoses were divided into non-neoplastic, neoplastic and non- specific.Results: Age of women ranged from 22 to 86 years (mean 54.3±3.6) with the maximum number of patients between 50 to 60 years of age. Most common form of clinical presentation was an itchy white elevated lesion on the vulva (72 cases, 62.6%). The most common site for the lesions was labia minora (90 cases, 78.2%). Non neoplastic lesions were seen in 53 cases and neoplastic lesions were seen in 52 cases. There were 28 (53.8%) benign lesions while 24 cases (46.1%) were malignant. Squamous cell carcinoma was the most frequently diagnosed form accounting for 20 cases (83.3%). Rare tumours like Malignant melanoma, Merkel cell carcinoma and Neuroendocrine carcinoma formed 16.6% (n=4). Seven cases were premalignant. Two cases had non-specific histologic diagnosis showing mild chronic inflammation.Conclusions: Previous studies have reported that non-neoplastic lesions form around 70% of cases. However, in our study we found that the non-neoplastic and neoplastic lesions form equal number of cases (46%) which may be attributed to increased awareness or geographical variation.


2022 ◽  
Vol 8 (1) ◽  
pp. 124-131
Author(s):  
Paraag Kumar

Background: Carcinoma esophagus is the 6th most common cancer in India with an incidence of 5.04% It most commonly affects older age individuals, with incidence peaking in seventh and eighth decades of life. Adenocarcinoma (AC) and Squamous cell carcinoma (SCC) are the two main histological variants. Our aim was to study the risk factors, clinical and epidemiological profile of patients diagnosed with Esophageal Cancer from two tertiary care centres located in North India.Methods:This was a retrospective study carried in departments of gastroenterology of two tertiary care hospitals North India. Data was collected from respective institutes for the previous 1 year i.e. from 1st October 2020 to 30th September 2021. All patients presenting to Gastroenterology OPD or emergency with dysphagia who were diagnosed as having Carcinoma esophagus were included in the study.Results:A total of 106 patients were included in this study. There were 44 females & 66 males. The most common presenting complaint was Dysphagia (48%) followed by Loss of weight (26.4%), Vomiting (in 23.6%) and Odynophagia (22.6%). Involvement of the lower one third of the oesophagus was the most common (37.7%). SCC (Squamous Cell Carcinoma) was the most common type of oesophageal carcinoma in this study, seen approximately in 80% of cases.Conclusion:Our study from North India suggested poor oral hygiene as a strong risk for carcinoma esophagus Males were more commonly affected and SCC was the predominant variant.


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