Abstract
Esophageal cancer is one of the major health concerns in Southeast Asian countries, including Thailand. However, only a limited number of studies have been reported from this region. This study was designed to evaluate the prevalence, clinical characteristics and survival rate of esophageal cancer in Thailand. Clinical information, histological features and endoscopic findings were collected from a tertiary care center in central region of Thailand between September 2011- November 2014 and reviewed. A total of 64 esophageal cancer patients including 58 men and 6 women with mean age of 62.6 years were enrolled. Common presenting symptoms were dysphagia (74%), dyspepsia (10%) and hematemesis (8%). Mean duration of symptoms prior to diagnosis was 72 days. Esophageal stenosis with contact bleeding was the most common endoscopic finding (55.6%). The location of cancer was found in proximal (16%), middle (50%) and distal (34%) esophagus. Squamous cell carcinoma was far more common histology than adenocarcinoma (84.2% vs 10.5%). However, esophageal adenocarcinoma was significantly more common than squamous cell carcinoma in distal area of esophagus (100% vs 22.9%; p=0.0001, OR=1.6, 95%CI=1.1-2.2). Esophageal cancer stages 3 and 4 accounted for 35.2% and 59.3% respectively. Overall 2-year survival rate was 20% and only 16% in metastatic patients. Most esophageal cancer patients in Thailand have squamous cell carcinoma and nearly all present at advanced stage with a grave prognosis. Screening of high risk individuals and early detection might be important keys to improve the survival rate and treatment outcome in Thailand.
Highlights
Esophageal cancer is currently the ninth common cancer in Thailand especially in male gender
In the past 40 years, the incidence of esophageal adenocarcinoma in western countries has increased by 600% (Bosetti et al, 2008; Eslick 2009)
The cancer at the gastroesophageal (GE) junction that some countries count it as the esophageal cancer, but some countries classified it as the malignant of gastric cardia or proximal gastric cancer (Vilaichone et al, 2014)
Summary
Esophageal cancer is currently the ninth common cancer in Thailand especially in male gender. This study was designed to evaluate the prevalence, clinical characteristics and survival rate of esophageal cancer in Thailand. Squamous cell carcinoma was far more common histology than adenocarcinoma (84.2% vs 10.5%). Conclusions: Most esophageal cancer patients in Thailand have squamous cell carcinoma and most present at advanced stage with a grave prognosis.
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