Title: Correlation between duration of Dysphagia and Stage of Esophageal Cancer at the time of presentation - An observational study from a tertiary care centre of Eastern India
Authors: Dr Soumik Ghosh, Dr Amitabha Manna, Dr Arup Chakraborty
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.108
Abstract
Introduction
Upper gastrointestinal (UGI) cancers (of the oesophagus and stomach) characteristically present at a late stage in the world. This contributes to the poor overall 5-year survival rates of patients with UGI cancer, which are 13 % for those with oesophageal cancer 1. BB
The management of esophageal cancer remains clinically challenging, not only in terms of identifying patients at high risk, but also because of the overall poor prognosis of the disease. Most esophageal cancers are diagnosed after symptoms develop and tumors are locally advanced.2
In contrast, in countries like India, there is a higher incidence of esophageal squamous cell carcinoma (SCC) in comparison to developed countries. Currently, SCC is the most common type of esophageal cancer in the Indian subcontinent.[3]
The National Cancer Registry Programme (NCRP) instituted by the Indian Council of Medical Research (ICMR) has information on cancer incidence and mortality in the community covering 10% of the country's population. Although the coverage is still low, it gives a fair idea of the pattern of cancer incidence emerging in various regions or parts of the country. The Northeast registry tops the chart in relation to carcinoma of the esophagus, for both men and women.[4]
Population-based data suggest that esophageal cancer incidence peaks in the sixth decade in most parts of the world.[5]
Typical symptoms of esophageal carcinoma are dysphagia[6], vomiting, loss of body weight, and gastrointestinal bleeding, Most esophageal cancers are diagnosed after symptoms like dysphagia develop and tumors are locally advanced.[7]. [8].
In the earliest stages, when it's easiest to treat, esophageal cancer has very few symptoms, so unfortunately it's rarely caught early. As esophageal cancer begins to progress and advance to the later stages, symptoms become more apparent, and the cancer becomes more difficult to treat.[9]
Survival rates depend on several factors, including the stage of the cancer when it is first diagnosed. As the stage advances, the overall survival decreases. The 5-year survival rate of people with cancer located only in the esophagus is 43%. The 5-year survival rate for those with disease that has spread to surrounding tissues or organs and/or the regional lymph nodes is 23%. If it has spread to distant parts of the body, the survival rate is 5%.[10]
In this study we assessed the average duration of dysphagia at the time of presentation and the stage at the time of presentation at Medical College & Hospital, Kolkata, to state the necessity of earliest investigative work up to detect esophageal cancer at early stage to improve treatment outcome and overall survival in this cancer.
