CHANGING PATTERN OF ESOPHAGEAL CARCINOMA: A
REVIEW OF 104 CASES
ABSTRACT
INTRODUCTION:
Esophageal cancer is one of the most virulent tumors with a poor prognosis. The
highest incidence of esophageal cancers is in the “Asian esophageal cancer belt”. Squamous
cell cancer is the commonest type of esophageal carcinoma worldwide. There are marked
geographic variations in the incidence of squamous cell esophageal cancer. 80-90% of
esophageal malignancies are squamous cell cancers in most developing and Asian countries.
The incidence of squamous cell esophageal cancer has decreased over the past two
decades by approximately 35% in most Western countries and in some parts of Asia, and
there has been a dramatic increase by four fold in the incidence of esophageal
adenocarcinoma in the Western countries. This study is aimed for looking this changing
pattern of subtypes of esophageal carcinomas.
MATERIAL AND METHODS:
This was a descriptive cross sectional study conducted in the department of
Gastroenterology and Hepatology PGMI/LRH, Peshawar from July 2013 to June 2014.
Patients with only esophageal dysphagia were included in the study. Whereas, patients with
oropharyngeal dysphagia were excluded from the study. All patients underwent upper GI
endoscopy and biopsies were taken of the esophageal lesions. Histopathology reports along
with bio data of the patients were included in the study.
RESULTS:
Total no. of patients with esophageal carcinoma was 104. Out of these patients
50 (48.1%) were male and 54(51.9%) were female with mean age of 58.09±10.16. Amongst
them, 70 (67.3%) were patients of squamous cell carcinoma and 34 (32.7%) of
adenocarcinoma. Most of the tumors were located in the middle third (53.84%), followed by
lower third (38.46%) and upper third (7.69%) of the esophagus.
CONCLUSION:
Esophageal carcinoma is the predominant causes of esophageal dysphagia. Squamous
cell carcinoma is still the predominant histological subtype of the esophageal carcinoma,
however, changing pattern has been observed. Our study showed two fold increase in the
prevelance of adenocarcinoma in our population. The change pattern is because of changing
life style, increasing obesity and GERD. Change in the gender distribution has also been
observed. Both genders are now almost equally affected.
KEY WORDS:
Esophageal carcinoma (EC), squamous cell carcinoma (SCC), adenocarcinoma, dysphagia.
HAMIDULLAH, ABBAS KHAN, AAMIR GHAFOOR KHAN,
CONTACT NO: 0312-9399756