Clinicopathological features of superficial esophageal squamous cell carcinomas in patients without history of smoking and drinking

Abstract

Abstract Introduction/Objective Cigarette smoking and drinking are the major causative risk factors for esophageal squamous cell carcinoma (ESCC). ESCCs in patients without history of smoking and drinking account for approximately 5% of all ESCCs. Clinicopathological features of superficial ESCCs in patients without history of smoking and drinking have not been well investigated. The aim of this study is to clarify the clinicopathological features of superficial ESCCs in patients without history of smoking and drinking. Methods/Case Report A multicenter study including 12 leading institutions of the Japan Research Society of Early Esophageal Cancer and Chromoendoscopy was conducted. Clinical data and pathological features of 108 superficial ESCCs in endoscopic submucosal dissection (ESD) specimens of 102 patients without history of smoking and drinking (NSND group) were reviewed. For comparison, clinicopathological features of 767 superficial ESCCs in ESD specimens of 544 patients with history of smoking and drinking (SD group) were also reviewed. Clinicopathological features including age, sex, synchronous/metachronous cancer, gastroesophageal reflux disease (GERD), tumor size, tumor site, macroscopic type, Lugol-voiding lesion (LVL), invasion depth, and lymphovascular invasion were analyzed in both NSND group and SD group. LVLs were graded according to the number of LVLs in preoperative endoscopic examination (grade A, no lesions; B, 1 – 9 lesions; C, more than 9 lesions). Results (if a Case Study enter NA) The univariate analysis revealed that female predominance (95.1% vs. 11.6%, p<0.001), absence of synchronous/metachronous cancer (81.4% vs. 60.8%, p<0.001), grade A LVLs (74.5% vs. 6.6%, p<0.001), presence of GERD (42.2% vs. 18.0%, p<0.001), tumor location at the posterior wall (58.3% vs. 47.5%, p<0.005), and 0-IIa macroscopic type (14.8% vs. 3.0%, p<0.001) were significantly more frequently observed in NSND group than SD group. Conclusion ESCCs in patients without history of smoking and drinking are characterized by female predominance, absence of synchronous/metachronous cancer, grade A LVLs, presence of GERD, tumor location at the posterior wall, and 0-IIa macroscopic type.