Endoscopic and clinicopathological patterns of esophageal cancer in Tanzania: experiences from two tertiary health institutions

Abstract

BackgroundEsophageal cancer is one of the most serious gastrointestinal cancer worldwide, owing to its rapid development and fatal prognoses in most cases. There is a paucity of published data regarding esophageal cancer in Tanzania and the study area in particular. This study was conducted to describe the endoscopic and clinicopathological patterns of esophageal cancer in this part of the world. The study provides baseline local data for future comparison.MethodsThis was a retrospective study of histologically confirmed cases of esophageal cancer seen at Bugando Medical Center and Muhimbili National Hospital between March 2008 and February 2013. Data were retrieved from medical record computer database and analyzed using SPSS computer software version 17.0.ResultsA total of 328 esophageal cancer patients were enrolled in the study, representing 25.3% of all malignant gastrointestinal tract tumors. The male to female ratio was 2.2:1. The median age of patients at presentation was 47 years. The majority of patients (86.6%) were peasants coming from the rural areas. Smoking and alcohol consumption were documented in 74.7% and 61.6% of patients respectively. Family history of esophageal cancer was reported in 4.6% of cases. The majority of patients (81.7%) presented late with advanced stage of cancer. Progressive dysphagia and weight loss were the most common presenting symptoms occurring in all patients. The middle third esophagus (58.5%) was the most frequent anatomical site for esophageal cancer followed by lower third (27.4%) and upper third esophagus (10.4%). Squamous cell carcinoma (96.0%) was the most common histopathological type. Adenocarcinoma occurred in 13 (4.0%) patients. TNM staging was documented in only 104 (31.7%) patients. Of these, 102(98.1%) patients were diagnosed with advanced esophageal cancer (Stages III and IV). According to tumor grading, most of tumors were moderately differentiated accounting for 56.1% of cases. Distant metastasis was documented in 43.3% of patients.ConclusionEsophageal cancer is not uncommon in this region and shows a trend towards a relative young age at presentation and the majority of patients present late with advanced stage. There is a need for screening of high-risk populations and detecting esophageal cancer at an early stage in order to improve chances for successful treatment and survival.

Clinicopathological Characteristics of Ca Oesophagus – Experience From a Tertiary Care Centre in North-East India

“…The male predominance demonstrated by Mabula D Mchembe et al 5 in their study was in keeping with previous observation reported in a study performed elsewhere. However, equal gender distribution was reported in previous studies from Nigeria and Kenya.…”

Clinical and epidemiologic variations of esophageal cancer in Tanzania

“…The country has the goal of establishing more cancer centers in the future to avoid patients missing treatment. Finally, missing data was another limitation for this study [25,26] . HIV status is not commonly recorded for EC patients in Tanzania, as they receive the same treatment regardless of HIV condition.…”

To study the short-term outcome of multimodality treatment on morbidity and quality of life in patients with carcinoma oesophagus

“…8,9 Study done by Mchembe MD et al observed that grade IV dysphagia (43%) was most common at the time of presentation followed by least common grade II dysphagia (4.6%) that was dissimilar to present study. 10 Histopathological examination in our study revealed that most patients 92.50% had SCC and minimum patients 7.50% had adenocarcinoma and same was observed by Multimodality treatment and survival of patients was seen for carcinoma oesophagus, neoadjuvant therapy which was followed by surgery, it was found that in present study perioperative morbidity and mortality is higher after neoadjuvant chemotherapy and radiotherapy and as observed by Keditsu KK et al 12 MRC studies showed benefit with neoadjuvant chemotherapy and Sjoquist KM et al in meta-analysis found that definite survival benefit with preoperative chemotherapy in locally advanced oesophageal cancers. 13,14 The metaanalysis conducted by Arnott et al reported a poor benefit rate with preoperative radiotherapy alone.…”