Histologically Confirmed Carcinoma of the Oesophagus; Study from the Niger Delta

Abstract

Background: Carcinoma of the oesophagus is amongst the top ten cancers worldwide. It shows marked variation in incidence, types and outcome in the various regions of the world. Adenocarcinoma is the main variant worldwide whereas squamous cell carcinoma appears more common in developing countries. Aim of our Study: We mean to ascertain the hospital incidence and epidemiology of patients presenting with histologically confirmed oesophageal cancer. Patients and Methods: This is a retrospective study spanning from January 2008 to December 2014. It is an evaluation and audit of our management of patients with histologically confirmed cases of oesophageal cancer. Results: A total of 42 cases were enrolled in the study. The male: female ratio was 2.2:1. The mean age was 60.1 years, with the mean male age being 62.3 yrs and female 55.1 yrs. All patients presented with dysphagia and 92.9% had some weight loss, with 31% presenting with cachexia. A greater percentage of patients (83.3%) were from the Niger Delta area, residing at the riverine areas. 54.8% were documented to use local gin. The greater percentage (85.7) of patients presented with stage 4 disease. The histological type were squamous cell carcinoma occurring in 85.7% of patients and 14.3% being adenocarcinoma. The tumour was mainly located in the mid portion of the oesophagus 59.5% and 35.7% were located at the lower oesophagus and gastro-oesophageal junction with only 4.8% at the upper thoracic and cervical oesophagus. All had oesophagoscopy and biopsy done either in the endoscopy suite (awake or conscious sedation) or in the theater. Oesophageal intubation was only feasible in 7patients (16.7%) with only 3(7%) patients having oesophagectomy with gastric pull-up.  Conclusion: Oesophageal carcinoma is usually squamous and in the middle third of the thoracic oesophagus. Most patients present late with palliation being the only feasible treatment.