Apoorva Srijayadeva

Assistant Professor, Department of Medicine, Srinivasa Medical College, Mangalore.

Email: drapoorvas@gmail.com

RESULTS

Graph 1: Sex Distribution Graph 2: Presenting Symptoms Graph 3: Endoscopic Signs

        Graph 5: Known Carcinogen Addiction                                        Graph 6: Histology Variety

Table 1:

Table 2:

Table 3: Endoscopy Level

The most common site was around 30 to 35 cms from the central incisors. This was followed by around 20 to 25 cms.

DISCUSSION

In our study the males were predominant. There were 41 males and 19 females. The predomince of sex can be mainly due to the fact that they are the dominant sex and go outside for work where they will be exposed to a variety of factors that may directly or indirectly cause the disease. Also the fact that they have a tendency to practice Habits of smoking, Drinking and also chewing betel nuts which can be considered to be the other factor. The male population face this problem in the sixth and seventh decade life and the females suffer from this a decade afterwards as suggested by our study. But the number of females in the study was less so a definitive conclusion cannot be concluded. Vomiting, Regurgitation, Odynophagia and dysphagia were the most common symptoms. Dysphagia was presented in almost all the cases. The mechanical restriction is perhaps the most common symptoms that will make the patient bring himself to the OPDs than any other symptoms. On Endoscopic Examination the ulcerative forms were the most common variety followed by proliferative nodular and then followed by the mixed variety. It was indeed surprising that none of the patients complained or turned themselves in the OPDs with hematemesis. The number of people that had an addiction to a known carcinogen was rather very high. They formed 66.66 per cent of the total population that were taken for the study. 20 had a habit or addiction to smoking, 12 were addicted to alcohol and around 33 were addicted to chewing betel nut with various permutations and combinations. Majority of them had squamous 66.66 per cent and the rest had adenocarcinoma. When our study was compared to a similar study conducted by Premaletha Narayanan et al 9 In their study majority of the patients in our study were above 60 years age in both the sexes with males outnumbering females in all age groups. Dysphagia is one of the earliest and predominant presenting symptoms of oesophageal carcinoma. Nearly, 80% of the patients in our study has dysphagia as the most common presenting symptom though patients with tumour located <20 cms cm presented predominantly with odynophagia. Squamous cell carcinoma still is the predominant histological subtype in Asian nations where most of the cases occur in middle or lower third.13 The recent increase in oesophageal adenocarcinoma was attributed to increase in erosive reflux diseases. Nearly, 85% of the lesions in our study occurred in the mid and lower oesophagus with noduloulcerative morphology. In a study conducted on nearly 400 EC patients in Japan, two most frequent morphological types were “ulcerative localised” and “ulcerated infiltrative” type (JSED types 2 and 3).14 Histological grade is known to affect lymph node metastasis. In a study by Bollschweiler et al, 15 it was reported that G1/G2 histology was associated with a lower rate of lymph node metastasis compared with G3 in oesophageal carcinoma. In our study, 72 (69.23%) patients had welldifferentiated oesophageal carcinoma, 26 (25%) patients had moderately-differentiated oesophageal lesions. Liver is the most common site of distant metastasis found in 35 (33.6%) patients. Our study stands in agreement with the other study conducted by Premaletha Narayanan et al ⁹.

CONCLUSION

Clinical profile of patients suffering from Oesophageal Cancer has been successfully built. This study is intended to help the clinicians understand the severity and the patient profile so as to start the prompt treatment as soon as possible.

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