scholarly journals More or less surgery for esophageal cancer: Extent of lymphadenectomy in esophagectomy for squamous cell esophageal carcinoma: How much is necessary?

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.


2012 ◽  
Vol 2 (4) ◽  
pp. 277-281
Author(s):  
CB Pun ◽  
G Aryal ◽  
R Basyal ◽  
S Shrestha ◽  
T Pathak ◽  
...  

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


1994 ◽  
Vol 5 ◽  
pp. S17-S26 ◽  
Author(s):  
U. Fink ◽  
H.J. Stein ◽  
H. Bochtler ◽  
J.D. Roder ◽  
H.J. Wilke ◽  
...  

2020 ◽  
Vol 38 (23) ◽  
pp. 2677-2694 ◽  
Author(s):  
Manish A. Shah ◽  
Erin B. Kennedy ◽  
Daniel V. Catenacci ◽  
Dana C. Deighton ◽  
Karyn A. Goodman ◽  
...  

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 .


2020 ◽  
Vol 5 ◽  
pp. 108-112
Author(s):  
Deepjyoti Kalita ◽  
Srinivas Bannoth ◽  
Joydeep Purkayastha ◽  
J. D. Sharma ◽  
Abhijit Talukdar ◽  
...  

Objectives: Esophageal cancer both squamous cell (SCC) and adenocarcinoma have poor outcomes with high morbidity and mortality. Our hospital-based registry for the year 2017–2018 showed that esophageal cancer constituted 22.7% of the annual caseload. The main objective of this study was to determine the presence of HER-2 receptors in patients with esophageal carcinoma in our region. Material and Methods: From September 2018 to September 2019, data regarding the expression of HER-2 receptors was analyzed in 133 patients of esophageal carcinoma. Data were statistically described as frequencies (number of cases) and percentages where appropriate. Chi-square and Fischer’s exact test was used to find out the association between categorical variables. A P < 0.05 was considered as statistical significant at 95% confidence interval. The statistical analysis was performed using SSPS software version 17.0. Results: A total of 133 patients were taken into study. The majority of patients were males (96) with a mean age of 52 years. Squamous cell carcinoma was predominant histology. HER-2 receptor positivity was seen in 6.01% of patients. Patients with HER-2 receptor positivity presented in advanced stage with poor functional status and poor grades of differentiation. Statistically significant correlation of Her-2 expression was seen with stage (P = 0.001) and pathology of tumor (P = 0.0001). Conclusion: Squamous cell carcinoma of esophagus still predominates in Northeast part of India. For studying the role of effective targeted therapies, knowledge of frequency of HER-2 receptor positivity is of utmost importance in our population and our study aims to answer this question. The present study shows a low prevalence of HER-2 neu overexpression in our community, probably due to the disproportionately high incidence of SCC compared to adenocarcinoma. Patients with HER-2 receptor positivity presented in advanced stage with poor functional status and poor grades of differentiation.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Gunnar Herlin ◽  
Lars Lundell ◽  
Åke Öst ◽  
Peter Aspelin ◽  
Leif Svensson ◽  
...  

Background. Somatostatin receptors (SSTRs) are over-expressed in several tumors making it possible for imaging with labelled SSTR. A previous study showed feasibility to image oesophageal cancer with SSTR analogue99mTc-depreotide.Purpose. (1) To investigate expression of the SSTRs in different types of esophageal carcinoma and (2) to correlate such an expression with99mTc-depreotide uptake in these lesions.Material and Methods. Total 28 patients (17 with esophageal cancer and 11 with Barrett’s esophagus) were examined with99mTc-depreotide scintigraphy. The SSTR2A, SSTR2B, SSTR3, and SSTR5 were analyzed immunohistochemically in the lesion samples.Results. Among the patients with adenocarcinoma 10/11 expressed different amounts of SSTRs, while SSTRs were absent in 5/6 patients with Squamous cell carcinoma (Sqcc). There was no correlation neither between the99mTc-depreotide uptake and the amount of SSTRs nor between the amount of SSTRs and differentiation grade of the tumor.Conclusions. (1) SSTRs are expressed in esophageal carcinoma and more abundantly so in adenocancer specimens; (2) in vivo99mTc-depreotide uptake does not obviously correlate with the immunohistochemically detection of SSTRs of different subtypes in esophageal carcinoma.


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.


2006 ◽  
Vol 119 (7) ◽  
pp. 1717-1722 ◽  
Author(s):  
Antonio Rosato ◽  
Michela Pivetta ◽  
Anna Parenti ◽  
Gaetano A. Iaderosa ◽  
Alessia Zoso ◽  
...  

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