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Oesophageal carcinoma: endoscopic and clinical findings in 258 patients

Published online by Cambridge University Press:  29 June 2007

H. J. Puhakka*
Affiliation:
Department of Otolaryngology, University Central Hospital, SF 20520, Turku, Finland.
K. Aitsalo
Affiliation:
Department of Otolaryngology, University Central Hospital, SF 20520, Turku, Finland.
*
Heikki J. Puhakka, M. D., Department of Otolaryngology, University Central Hospital, SF-20520 Turku, Finland.

Abstract

During the 10-year period 1917–1980, oesophagoscopy was carried out on a total of 3235 patients in the Department of Otolaryngology, Turku University Central Hospital, Finland. Oesophageal carcinoma was diagnosed in 258 patients, 113 (44 per cent) men and 145 (56 per cent) women. The diagnosis was verified in 228 cases (88.4 per cent) by using an optical rigid oesophagoscope and in 30 cases (11.6 per cent) by a fibreoptic endoscope. The most common and earliest symptom was difficulty in swallowing in 50 per cent of cases. In 44 per cent of patients the symptoms persisted over six months before diagnosis. Upper and middle thoracic portions of the oesophagus were the sites of origin of the carcinoma in 57 per cent of the patients. The macroscopic picture obtained by oesophagoscopy was regarded as malignant in 83 per cent of patients and extraoesophageal spread of the tumour was estimated to be present in 48 per cent of patients by the time of diagnosis. Histological studies showed the tumour to be squamous cell carcinoma in 62 per cent of patients and in 24 per cent well differentiated. Squamous cell carcinoma was seen more often in men than in women. In patients with carcinoma in situ, alcohol and tobacco were regarded as aetiological factors in 53 per cent of cases. The need for repeated oesophagoscopy in patients with symptoms related to swallowing is stressed.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1988

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References

Appelquist, P. and Salmo, M. (1980) Lye corrosion carcinoma of the esophagus. Cancer, 45: 26552658.3.0.CO;2-P>CrossRefGoogle Scholar
Dancygier, H. and Classen, M. (1986) How can we diagnose the depth of cancer invasion in the esophagus? Endoscopy, 18: (Suppl.3) 1921.CrossRefGoogle ScholarPubMed
Dowlatshahi, K., Skinner, B. and De Meester, T. R. (1985) Evaluation of brush cytology as an independent technique for detection of esophageal carcinoma. Journal of Thoracic and Cardiovascular Surgery, 89: 848851.CrossRefGoogle ScholarPubMed
Endo, M., Takeshita, K. and Yoshida, M. (1986) How can we diagnose the early stage of esophageal cancer? Endoscopic diagnosis. Endoscopy, 18: (Suppl. 3), 1118.CrossRefGoogle ScholarPubMed
Freni, S. C. (1984) Long-term trends in the incidence rates of upper digestive tract cancer in the Netherland Antilles. Cancer, 53: 16181624.3.0.CO;2-4>CrossRefGoogle Scholar
Gatzinsky, P., Berglin W-O, E., Dernevik, L., Larsson, I. and William-Olsson, G. (1985). Resectional operations and long-term results in carcinoma of the esophagus. Journal of Thoracic and Cardiovascular Surgery, 89: 7176.CrossRefGoogle ScholarPubMed
Guanrei, Y., He, H., Sungliang, Q. and Yuming, C. (1982). Endoscopic diagnosis of 115 cases of early esophageal carcinoma. Endoscopy, 14: 157161.CrossRefGoogle ScholarPubMed
Hennessy, T. P. J. and O'Connel, R. O. (1984) Surgical treatment of squamous cell carcinoma of the oesophagus. British Journal of Surgery, 71: 750751.CrossRefGoogle ScholarPubMed
Hopkins, R. A. and Poslethwait, R. W. (1981) Caustic burns and carcinoma of the esophagus. Annals of Surgery, 194: 146148.CrossRefGoogle ScholarPubMed
Ihekwaba, F. N. and Solkanke, T. F. (1984) Carcinoma of the oesophagus. British Journal of Surgery, 71: 116118.CrossRefGoogle ScholarPubMed
Kiviranta, U. K. (1952) Corrosion carcinoma of the esophagus. 381 cases of corrosion and nine cases of corrosion carcinoma. Acta Otolaryngologica, 42: 8995.CrossRefGoogle ScholarPubMed
Lortat-Jacob, J. L. (1969). Cardiospasm and esophageal carcinoma. Report of 24 cases. Surgery, 66: 969975.Google ScholarPubMed
Mannell, A. (1982) Carcinoma of the esophagus. In: Ravitch, M. M. (Editor), Current problems of Surgery, Year Book, Vol. 19 (10) (1982). Medical Publishers, Inc., 1982, pp. 553647.Google Scholar
McGlashan, N. D., Bradshaw, E. and Harringtion, J. S. (1982) Cancer of the esophagus and of the use of tobacco and alcohol beverages in Transkei. International Journal of Cancer, 29: 249256.CrossRefGoogle ScholarPubMed
Naef, A. P., Savary, M. and Ozzello, L. (1975) Columnar-lined lower esophagus: An acquired lesion with malignant pre-dispositon: Report on 140 cases of Barret's esophagus with 12 adenocarcinomas. Journal of Thoracic and Cardiovascular Surgery, 70: 826835.CrossRefGoogle Scholar
Picus, D., Balfe, D. M., Koehler, R. E., Roper, C. L. and Owen, J. W. (1983) Computed tomography in the staging of esophageal carcinoma. Radiology, 146: 433438.CrossRefGoogle ScholarPubMed
Ransom, J. M., Patel, G. K., Clift, C. A. et al. (1982). Extended and limited types of Barret's esophagus in the adult. Annals of Thoracic Surgery, 33: 1927.CrossRefGoogle Scholar
Savary, M. and Miller, G. (1978) The esophagus. Handbook and atlas of endoscopy. Gassman, Solothurn, 1977.Google Scholar
Skinner, D. B., Walther, B. C., Riddell, R. H., Schmidt, H., Iascone, C. and DeMeester, T. R. (1983) Barret's esophagus: Comparison of benign and malignant cases. Annals of Surgery, 198: 554565.CrossRefGoogle Scholar
Spechler, S. J. (1985) The risk of cancer in Barrets esophagus. In: Barret's esophagus. Spechler, St., Raj, K. G. (eds.): Elsevier, New York-Amsterdam-Oxford, 1985. pp. 189197.Google Scholar
Ti, T. K. (1983) Oesophageal carcinoma associated with corrosive injury-prevention and treatment by oesphageal resection. British Journal of Surgery, 70: 223225.CrossRefGoogle Scholar
van Rensburg, S., Bradshaw, E. S., Bradshaw, D. and Rose, E. F. (1985) Oesophageal cancer in Zulu men, South Africa: A case control study. British Journal of Cancer, 51: 399405.CrossRefGoogle ScholarPubMed
Weiser, H. F., Lange, R. and Feussner, H. (1986) How can we diagnose the early stage of esophageal cancer? Endoscopy, 18 (Suppl 3), 210.CrossRefGoogle ScholarPubMed