ESOPHAGEAL CANCER IN SOUTH INDIA; AN INSTITUTIONAL 5-YEARS RETROSPECTIVE ANALYSIS ON ITS CLINICOPATHOLOGY AND RISK FACTORS OF DISTANT METASTASIS

Abstract

Context: Esophageal cancer (EC) is highly fatal malignancy with considerable geographical variation in its distribution, etiologies, histopathological subtypes, and mortality. Methods: A retrospective analysis was performed to study the clinicopathology, and risk factors of distant metastasis (DM) among 255 cases of EC treated between January 2015 and December 2019 in a tertiary cancer center in south India. Statistical analysis: Chi-square test and multivariate analysis (MVA) were used for analysis. P < 0.05 was considered signicant. Results: The median age at diagnosis of EC was 57 years, higher for male. Younger EC patients (≤ 40 years) constituted 8.2%, and were commonly female, non-smoker, non-alcoholic, squamous cell carcinoma (SCC). Male: female ratio was 1.67:1. Lower thoracic esophagus was the commonest site. SCC was the commonest histology. Adenocarcinoma (ADC) was common among older age, male, esophagogastric junction (EGJ), high grade tumor, and carried higher risk of DM. ADC had higher propensity for liver metastasis, whereas SCC for lung metastasis. MVA showed the risk factors associated with DM were poor performance status (PS), delayed diagnosis, EGJ tumor, ADC histology, high grade tumor. Conclusion: Lower thoracic esophageal location and SCC histology remains the commonest type of EC in southern part of India. Younger EC patients are commonly female, nonsmokers, non alcoholic, SCC. ADC is common in male, older age. EGJ tumor are commonly ADC, high grade, and carries higher risk of DM, which warrants early diagnosis, aggressive systemic therapy in this subset of patients for improving the survival.