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

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.

Download Full-text

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171235 ◽

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.

Download Full-text

Retrospective Review of Esophageal Carcinoma: 3-Year Experience from a Tertiary Care Teaching Institute

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210716 ◽

2021 ◽

Vol 11 (7) ◽

pp. 111-118

Author(s):

Diptajit Paul ◽

Pawan Kumar ◽

Anil Kumar Dhull

Keyword(s):

Squamous Cell Carcinoma ◽

Esophageal Cancer ◽

Treatment Outcome ◽

Retrospective Study ◽

Esophageal Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Tertiary Care ◽

Care Hospital ◽

Advanced Stage

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.

Download Full-text

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

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e16095 ◽

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.

Download Full-text

Experience of Radical Radiotherapy for Patients with Stages I-III Squamous Cell Carcinoma of the Glottic Larynx

Faridpur Medical College Journal ◽

10.3329/fmcj.v10i2.30273 ◽

2016 ◽

Vol 10 (2) ◽

pp. 63-67

Author(s):

Md Nizamul Haque ◽

Sk Golam Mostafa ◽

Qamruzzaman Chowdhury ◽

Mokles Uddin ◽

Syed Akram Hussain ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Treatment Protocol ◽

Radical Radiotherapy ◽

Short Term ◽

Female Ratio ◽

Grade Ii ◽

Male To Female ◽

Conventionally Fractionated

This study was carried out from May 2012 to April 2013, on short term effects of Radical Radiotherapy for patients with Stages I-III squamous cell carcinoma of the glottic larynx at National Institute of Cancer Research and hospital, Mohakhali, Dhaka. A total of 50 biopsy proved squamous cell carcinoma of the glottis larynx were treated with radical Radiotherapy, total dose of which was 66Gy in 33 fractions over 7 weeks, conventionally fractionated with 200 cGy per fraction, one fraction per day and 5 fractions per week, using the machine 6 MV LINAC. The main outcome variables of the study were toxicities and clinical outcome of the patients. The peak age incidence was found in the age group of 51-60 years (56%). Among 50 patients, there were 82% males and 18% females and male to female ratio was 4.6:1. There were 86% found smokers and rests of the 14% patients were non smoker. Treatment related haematological and non-haematological acute and delayed toxicities were studied. Mucosities 28% (grade-II), skin reaction 78% (grade-II), anaemia 52% (grade-II), dysphagia 70% were the most common acute toxicities where as xerostomia 16% was the delayed side effect. With this treatment protocol, 86% patients responded completely.Faridpur Med. Coll. J. Jul 2015;10(2): 63-67

Download Full-text

Histological pattern of esophageal cancer at BP Koirala memorial cancer hospital in Nepal: a three year retrospective study

Journal of Pathology of Nepal ◽

10.3126/jpn.v2i4.6877 ◽

2012 ◽

Vol 2 (4) ◽

pp. 277-281

Author(s):

CB Pun ◽

G Aryal ◽

R Basyal ◽

S Shrestha ◽

T Pathak ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Esophageal Cancer ◽

Esophageal Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Signet Ring Cell ◽

Cancer Center ◽

Common Site ◽

Histological Pattern ◽

Cancer Hospital

Background: The incidence of esophageal adenocarcinoma is increasing in trends. Squamous cell carcinoma is associated with tobacco and alcohol consumption. Adenocarcinoma is often associated with a history of gastroesophageal reflux disease and Barrett's esophagus. The aim of this study was to find out the histological pattern of esophageal cancer in one of the largest Cancer center in Nepal.Materials and Methods: Between January 2008 and December 2011, a total of 106 cases of esophageal cancer were received in the department of pathology, BP Koirala Memorial Cancer Hospital. Relevant clinical data were retrieved from computer database of the hospital.Results: A total of 106 cases of esophageal carcinomas were diagnosed during a three years period. There were 68 (64.15%) cases of squamous cell carcinoma, 33 (31.13%) cases of adenocarcinoma including signet ring cell carcinoma, 4 (3.76%) cases of undifferentiated carcinoma and 1 (0.94%) case of small cell carcinoma. The esophageal cancer was most common in the age group of 61-70 years of age. Distal third of esophagus was the most common site for esophageal carcinoma, followed by middle esophagus and proximal esophagus.Conclusion: The most frequent type of esophageal carcinoma is squamous cell carcinoma followed by adenocarcinoma. Distal esophagus is the most common site with male preponderance.Journal of Pathology of Nepal (2012) Vol. 2, 277-281DOI: http://dx.doi.org/10.3126/jpn.v2i4.6877

Download Full-text

TUMOURS OF OROFACIAL REGION IN ZARIA NIGERIA: A SEVEN YEAR REVIEW

Caliphate Medical Journal ◽

10.47837/cmj.19770126.nma.20164347122 ◽

2016 ◽

Vol 4 (4) ◽

Author(s):

Mohammed A ◽

Mohammed U ◽

Abubakar N

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Northern Nigeria ◽

Odontogenic Tumour ◽

Tertiary Institution ◽

Female Ratio ◽

Odontogenic Tumours ◽

Orofacial Region ◽

Male To Female

BACKGROUND: Research and literature on orofacial tumours are seldom reported in this part of the world. This study will describe the histopathological features of orofacial tumours seen in a tertiary institution in northern Nigeria. AIMS/OBJECTIVE: To study the pattern of tumours of orofacial region in a tertiary institution in northern Nigeria and compare it with other centres. METHOD: This is a retrospective study in which surgical biopsy specimens seen over 7 year period were reviewed with respect to age, sex, site and histopathological characteristics. RESULTS: Of the 192 lesions of orofacial region that were diagnosed during the study period, there were 24(12.5%) odontogenic and 168(87.5%) of non-odontogenic tumours of which63 (32.8%) were benign and 105 (54.7%) malignant non-odontogenic tumours.The age rangefor odontogenic tumour was 12 year to 54 year, commonly seen in the second decade of life with a male to female ratio of 1.4:1. Ameloblastoma was the most common form 91.7 % .The benign non- odontogenic tumour consist of epithelial (30.2%), vascular tumours (30.2%), bone tumours (23.8%), fibrous and adipose tissue tumours (12.7%)) and neurogenic tumours(3.2%). It is predominantly seen in men with a male to female ratio of 1.25:1. Their ages range from 18 years to 54 years.On the other hand of benign non-odontogenic tumous, Pleomorphic adenoma forms 19.1% Which is the most common.Malignant non-odontogenic tumours are predominantly seen in male with male to female ratio of 1.3:1 and it is commoner in fifth, fourth and third decades of life with age range of12 years to 84 years. Squamous cell carcinoma was the most common malignant non-odontogenic tumourin both males and females and these constitute44.8%. CONCLUSION:Tumours of the orofacial region are diverse and are fairly common. This study have demonstrated that squamous cell carcinoma and ameloblastoma are the most common malignant nonodontogenic and benign odontogenic tumours seen res

Download Full-text

Frequency of different histopathological types of esophageal cancer patients at oncology department of a tertiary care hospital in Karachi

Journal of Fatima Jinnah Medical University ◽

10.37018/uqiz9862 ◽

2021 ◽

Vol 14 (4) ◽

pp. 161-165

Author(s):

Zoya Sheikh ◽

Ghulam Haider ◽

Khalil Ahmed ◽

Dr. Bhunisha

Keyword(s):

Squamous Cell Carcinoma ◽

Esophageal Cancer ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Carcinoma Of The Esophagus ◽

Histopathological Type

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.

Download Full-text

CLINICOPATHOLOGICAL STUDY OF ORAL LESIONS IN A TERTIARY CARE HOSPITAL

10.36106/gjra/7500641 ◽

2021 ◽

pp. 17-20

Author(s):

Sravani Ponnada ◽

Lakshmi Latchupatula ◽

Tadikonda Krishna Srivathsav ◽

Bhagyalakshmi Atla

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Oral Lesion ◽

Oral Lesions ◽

Care Hospital ◽

Common Site ◽

Female Ratio

Background: Oral cavity is a common site for various non-neoplastic and neoplastic lesions. Majority of lesions were neoplastic. Tobacco chewing, smoking and alcohol consumption were the common risk factors implicated in the etiology of malignant oral lesions. Squamous cell carcinoma was the most common lesion of the oral cavity. Aims&Objectives: To study the clinicopathological lesions of the oral cavity with respect to age, gender, location, clinical presentation, histopathological patterns and various risk factors. Materials And Methods: A retrospective study of 274 oral cavity lesions conducted for period of 2 years from January 2019 to December 2020 in the department of pathology, Andhra Medical College, Visakhapatnam, Andhra Pradesh. Results: In our study, the age range of the patients was from 3 years to 87 years. Majority of cases were seen in age group of 41- 50 years. Males were more commonly affected than females with a male to female ratio of 2.51:1. Majority of oral lesions were malignant. Squamous cell carcinoma was the most common oral lesion. Tongue was the most common site involved in oral lesions. Mucocele was the commonest non-neoplastic lesion and squamous papilloma was the most common benign lesion. Leucoplakia was the most common premalignant lesion and Squamous cell carcinoma was the commonest malignant lesion. Conclusion: Majority of oral lesions were malignant. Squamous cell carcinoma was the most common oral lesion. Early and accurate identication of potentially malignant oral lesions is important and essential for prevention of morbidity, mortality and for proper treatment of cases. Along with clinical examination and laboratory investigations, histopathological examination is still the gold standard to establish a denitive diagnosis and for conrmation of the nature and origin of oral lesions.

Download Full-text

Treatment of Locally Advanced Esophageal Carcinoma: ASCO Guideline

Journal of Clinical Oncology ◽

10.1200/jco.20.00866 ◽

2020 ◽

Vol 38 (23) ◽

pp. 2677-2694 ◽

Cited By ~ 1

Author(s):

Manish A. Shah ◽

Erin B. Kennedy ◽

Daniel V. Catenacci ◽

Dana C. Deighton ◽

Karyn A. Goodman ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Esophageal Cancer ◽

Esophageal Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Clinical Decision Making ◽

Locally Advanced ◽

Preoperative Chemoradiotherapy ◽

Advanced Esophageal Cancer ◽

Locally Advanced Esophageal Cancer

PURPOSE To develop an evidence-based clinical practice guideline to assist in clinical decision making for patients with locally advanced esophageal cancer. METHODS ASCO convened an Expert Panel to conduct a systematic review of the more recently published literature (1999-2019) on therapy options for patients with locally advanced esophageal cancer and provide recommended care options for this patient population. RESULTS Seventeen randomized controlled trials met the inclusion criteria. Where possible, data were extracted separately for squamous cell carcinoma and adenocarcinoma. RECOMMENDATIONS Multimodality therapy for patients with locally advanced esophageal carcinoma is recommended. For the subgroup of patients with adenocarcinoma, preoperative chemoradiotherapy or perioperative chemotherapy should be offered. For the subgroup of patients with squamous cell carcinoma, preoperative chemoradiotherapy or chemoradiotherapy without surgery should be offered. Additional subgroup considerations are provided to assist with implementation of these recommendations. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines .

Download Full-text

Clinical profile of oral squamous cell carcinoma patients attending a tertiary care hospital

Bangladesh Medical Journal Khulna ◽

10.3329/bmjk.v47i1-2.22554 ◽

2015 ◽

Vol 47 (1-2) ◽

pp. 3-6 ◽

Cited By ~ 1

Author(s):

Sheikh Shahidur Rahman ◽

Mrinal Kanti Sarker ◽

Md Haider Ali Khan ◽

Sushanta Shekhar Biswas ◽

Moni Mohan Saha

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Tertiary Care ◽

Clinical Profile ◽

Major Public Health Problem ◽

Care Hospital ◽

Dental Surgery ◽

Female Ratio

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

Download Full-text