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Aug 6, 2023Keywords:
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Distal oesophageal cancer and its histological pattern: A single centre five years retrospective review
Abstract
Background: Esophageal carcinoma is a significant cause of morbidity and mortality among cancer patients in Tanzania. Squamous cell carcinoma is the most predominant subtype encountered. But the adenocarcinoma might also occur, especially in the distal third of the esophagus. Risk factors and treatment of these two histological subtypes vary significantly. Hence it is important to understand the true prevalence of Distal oesophageal cancer and that of adenocarcinoma. This study aimed to understand the prevalence of Distal oesophageal cancer and that of adenocarcinoma.
Methods: This was a retrospective chart review for patients treated with oesophageal cancer from April 2013 to April 2017 at Muhimbili National hospital. Patients with Distal oesophageal cancer were identified and their socio -demography, Takita’s dysphagia grade, tumor length from the upper incisor teeth, endoscopic tumor morphology, histology and stage of the disease was abstracted. Data was analyzed using SPSS where descriptive statistics were computed. Associations were determined using chi-square test with significance set at <5%. Ethical approval was obtained from Muhimbili University Institutional Review Board.
Results: Distal oesophageal cancer made 34.1% of all esophageal cancers, with no variations over the five-year review. The mean age of patients with Distal oesophageal cancer was 59.7 years with female predominance at 2:1 for men. Adenocarcinoma was the most predominant histological subtype at 3:1 for squamous cell carcinoma. Low socio-economic status, alcohol drinking, smoking cigarettes and positive history suggestive of Gastro Oesophageal Reflux Disease were common among these patients. Most of the tumors are fungating with late presentation judged clinically with dysphagia as the most common presentation.
Conclusion: Clinicians and researchers should be aware of the higher incidence of Distal oesophageal cancer presenting with adenocarcinoma. Failure to recognize this unique entity in a region where squamous cell carcinoma is the most predominant type might result in misinterpretation of data and misallocation during treatment and prognostication.
