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Submitted
May 16, 2022
Published
April 11, 2022
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Abstract

BACKGROUND


Oesophageal and junctional cancer is an aggressive malignancy with poor prognosis even with multimodality treatment. The true nature of the presentation, management and its outcome is less known in our population. This study was done to provide clinicians with useful information about the disease epidemiology, stage of presentation and clinical picture of the disease in the setting of a developing country.


METHODS


All patients managed for oesophageal and esophagogastric junction (EGJ) tumours over six years were retrospectively studied for types and location of the tumour, treatments given and their outcomes.


RESULTS


A total of 76 patients, 62 (81.6 %) with the oesophageal and 14 (18.4 %) patients with EGJ carcinoma were included. The mean age was 68.2 years with a male to female ratio of 1.7. The most common tumour location in the oesophagus was the middle third (39.5 %). Siewert type II was the most common EGJ tumour. Squamous cell carcinoma (63.2 %) was the predominant histological type followed by adenocarcinoma (36.8 %). A total of 14 (18.4 %) patients were in stage III disease, 40 (52.6 %) locally advanced unresectable disease (IVA), and the remaining 22 (28.9 %) were having metastasis (stage IVB). Eighteen (23.7 %) patients required feeding jejunostomy as a palliative procedure, and 26 (34.2 %) underwent definitive chemoradiotherapy. Only 10 (13.2 %) patients underwent surgery with curative intent. There was no operative mortality. The mean survival in patients undergoing surgery with curative intent was 26.9 months (range 4-60 months) while the mean survival in the remaining patients was only 11 months (range: 3-18 months).


CONCLUSIONS


Squamous cell carcinoma is the predominant type and the middle and upper third are the most common locations of oesophageal carcinoma. Most of the patients present with advanced stage disease with poor survival.

Keywords

Cancer, Oesophagus, Esophagogastric Junction, Management, Survival.

Article Details

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This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite
Lokesh Shekher Jaiswal, & Narendra Pandit. (2022). Oesophageal and Esophagogastric Junctional Carcinoma- Management and Outcomes from an Academic Community Centre of Nepal. Journal of Evolution of Medical and Dental Sciences, 11(5), 542–545. https://doi.org/10.14260/jemds/2022/109
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References

  1. Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2019;144(8):1941-53.
  2. Pennathur A, Gibson MK, Jobe BA, et al. Oesophageal carcinoma. Lancet 2013;381(9864):400-12.
  3. Thakur B, Li H, Devkota M. Results of management of oesophagal and GE junction malignancies in Nepalese context. J Thorac Dis 2013;5(2):123-8.
  4. Thakur B, Zhang CS, Meng XL, et al. Eight-year experience in esophageal cancer surgery. Indian J Cancer 2011;48(1):34-9.
  5. Campbell NP, Villaflor VM. Neoadjuvant treatment of esophageal cancer. World J Gastroenterol 2010;16(30):3793-803.
  6. Napier KJ, Scheerer M, Misra S. Esophageal cancer: a review of epidemiology, pathogenesis, staging workup and treatment modalities. World J Gastrointest Oncol 2014;6(5):112-20.
  7. Zhang Y. Epidemiology of esophageal cancer. World J Gastroenterol 2013;19(34):5598-606.
  8. Bhome R, Desai D, Abraham P, et al. Esophageal adenocarcinoma versus squamous cell carcinoma: retrospective hospital-based analysis of a 12-year temporal trend. Indian J Gastroenterol 2012;31(6):340-2.
  9. Choksi D, Kolhe KM, Ingle M, et al. Esophageal carcinoma: An epidemiological analysis and study of the time trends over the last 20 years from a single center in India. J Family Med Prim Care 2020;9(3):1695-9.
  10. Arnal MJD, Arenas ÁF, Arbeloa ÁL. Esophageal cancer: risk factors, screening and endoscopic treatment in Western and Eastern countries. World J Gastroenterol 2015;21(26):7933-43.
  11. Arnold M, Laversanne M, Brown LM, et al. Predicting the future burden of esophageal cancer by histological subtype: International trends in incidence up to 2030. Am J Gastroenterol 2017;112(8):1247-55.
  12. Vizcaino AP, Moreno V, Lambert R, et al. Time trends incidence of both major histologic types of esophageal carcinomas in selected countries, 1973-1995. Int J Cancer 2002;99(6):860-8.
  13. Cooper SL, Russo JK, Chin S. Definitive chemoradiotherapy for esophageal carcinoma. Surg Clin North Am 2012;92(5):1213-48.
  14. Wang BY, Hung WH, Wu SC, et al. Comparison between esophagectomy and definitive chemoradiotherapy in patients with esophageal cancer. Ann Thorac Surg 2019;107(4):1060-7.
  15. Shapiro J, van Lanschot JJB, Hulshof MCCM, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol 2015;16(9):1090-8.