A Clinical Analysis Of Esophageal Cancer

Abstract

We treated 210 patients for esophageal cancer between January 1986 and December 1990. This report analyses the clinical features, survival rate, and prognostic factors affecting survival. Most patients were in their fifties and sixties and the mean age was 61.7 years. The ratio of male to female was 22.3 : 1. The most common symptom was dysphagia; the mean duration of illness was 3 months. There was a correlation between esophageal cancer and consumption of cigarettes and alcohol. The most frequent site of cancer was the middle thoracic esophagus. In order of frequency, 87 cases were of the protruding type, 41 cases were ulcerative and localized, 34 cases ulcerative and infiltrative, and 27 cases diffuse infiltrative as determined by endoscopy. The histologic types were squamous cell carcinoma in 206 patients, adenocarcinoma in two patients, and undifferentiated and adenosquamous carcinoma -in one patient each. The most common site of direct invasion was the aorta and the most frequent site of distant metastasis was the liver. The median survival duration for all patients was 10 months. The median survival by stage was 19 months for stage 1(7 cases of 168 patients), 19 months for stage 11(41 cases), 9.7 months for stage 111(89 cases), and 7.2 months for stage IV(31 cases)(p<0.05). The median survival duration by treatment group was 19.7 months for combined chemotherapy and radiotherapy(22.4% of all patients), 18.9 months for combined therapy including curative- operation(15.2%), 9.6 months for chemotherapy alone(31.9%), 5.0 months for radiotherapy alone(11.9%), 3.9 months for conservative treat ment(18.6%)(p<0.05). Prognostic factors affecting survival in esophageal cancer were stage of disease and treatment modality, therefore early diagnosis and combined therapy are warranted.