Surgical outcomes in patients with esophageal cancer in a third level center
DOI:
https://doi.org/10.5281/zenodo.14616876Keywords:
Gastrointestinal Diseases, Esophageal Neoplasms, Esophagectomy , Esophageal AdenocarcinomaAbstract
Background: Esophageal cancer is the seventh most diagnosed neoplasm, with a higher prevalence in men. Tobacco and alcohol consumption, gastroesophageal reflux disease, and Barrett’s esophagus are associated with the development of adenocarcinoma and squamous cell carcinoma.
Objective: To identify the clinical profile in patients with esophageal cancer at a tertiary care center.
Materials and methods: A cross-sectional, observational study. Patients with esophageal cancer were evaluated between January 2014 and July 2019. The study variables included sex, age, histological type, postoperative complications, mortality, and survival.
Results: A total of 34 patients were evaluated, with a mean age of 61.8 ± 8.9 years. 88.2% were men. Tumor location was as follows: lower third (76.5%), middle third (17.6%), and upper third (5.9%). The most common histological types were adenocarcinoma (67.6%) and squamous cell carcinoma (32.4%). Symptoms included: dysphagia in 34 (100%) and epigastric pain in 20 (58.8%). The types of surgeries performed were: transhiatal in 15 (44.1%), palliative in 15 (44.1%), Ivor Lewis in 1 (2.9%), and McKeown in 1 (2.9%). Postoperative complications included: respiratory (29.4%), anastomotic leak (20.6%), sepsis (11.8%), and fistula (2.9%). Mortality was 13 (38.2%) patients, and survival at 22 months was 22%.
Conclusions: Our study showed a higher prevalence of esophageal cancer in men over 60 years old with adenocarcinoma localized in the lower third of the esophagus. Despite chemotherapy treatment, patient survival remains poor due to late diagnosis in advanced stages of the disease, which limits tumor resectability and operability, leading to increased mortality.
Downloads
References
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209-249. Disponible en: https://doi.org/10.3322/ caac.21660
Huang J, Koulaouzidis A, Marlicz W, et al. Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries. Cancers (Basel). 2021;13(1):141. Disponible en: https://doi.org/10.3390/ cancers13010141
[INEGI (2015). Estadísticas de Mortalidad. Cubos dinámicos; y CONAPO (2015). Proyecciones de la Población 2010-2050.
Morgan E, Soerjomataram I, Rumgay H, et al. The Global Landscape of Esophageal Squamous Cell Carcinoma and Esophageal Adenocarcinoma Incidence and Mortality in 2020 and Projections to 2040: New Estimates From GLOBOCAN 2020. Gastroenterology. 2022;163(3):649-658.e2. Disponible en: https://doi.org/10.1053/j.gastro.2022.05.054
Qin X, Jia G, Zhou X, et al. Diet and Esophageal Cancer Risk: An Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies. Adv Nutr. 2022;13(6):2207-2216. Disponible en: https://doi.org/10.1093/advances/nmac087
Katada C, Yokoyama T, Yano T, et al. Drinking alcohol, smoking, multiple dysplastic lesions and the risk of field cancerization of squamous cell carcinoma in the esophagus and head and neck region. Annals of Oncology. 2019;30(6):296. Disponible en: https://doi.org/10.1093/annonc/mdz247.091 7.
Tarazi M, Chidambaram S, Markar S. Risk Factors of Esophageal Squamous Cell Carcinoma beyond Alcohol and Smoking. Cancers (Basel). 2021;13(5):1009. Disponible en: https:// doi.org/10.3390/cancers13051009
Uhlenhopp DJ, Then EO, Sunkara T, et al. Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin J Gastroenterol. 2020;13(6):1010-1021. Disponible en: doi:10.1007/s12328-020-01237-x
Yang J, Liu X, Cao S, et al. Understanding Esophageal Cancer: The Challenges and Opportunities for the Next Decade. Front Oncol. 2020;10:1727. Disponible en: https://doi.org/10.3389/ fonc.2020.01727
Li N, Sohal D. Current state of the art: immunotherapy in esophageal cancer and gastroesophageal junction cancer. Cancer Immunol Immunother. 2023;72(12):3939-3952. Disponible en: https://doi.org/10.1007/s00262-023-03566-5 11
Batra R, Malhotra GK, Singh S, et al. Managing Squamous Cell Esophageal Cancer. Surg Clin North Am. 2019;99(3):529- 541. Disponible en: https://doi.org/10.1016/j.suc.2019.02.006
DiSiena M, Perelman A, Birk J, et al. Esophageal Cancer: An Updated Review. South Med J. 2021;114(3):161-168. Disponible en: https://doi.org/10.1016/j.suc.2019.02.006
Li S, Xie K, Xiao X, et al. Correlation between sarcopenia and esophageal cancer: a narrative review. World J Surg Oncol. 2024;22(1):27. Disponible en: https://doi.org/10.1186/ s12957-024-03304-w
He S, Xu J, Liu X, et al. Advances and challenges in the treatment of esophageal cancer. Acta Pharmaceutica Sinica. 2021;11(11):3379-3392. Disponible en: https://doi.org/10.1016/j. apsb.2021.03.008
Ohkura Y, Miyata H, Konno H, et al. Development of a model predicting the risk of eight major postoperative complications after esophagectomy based on 10826 cases in the Japan National Clinical Database. J Surg Oncol. 2020;121(2):313-321. Disponible en: https://doi.org/10.1002/jso.25800
Watanabe M, Otake R, Kozuki R, et al. Recent progress in multidisciplinary treatment for patients with esophageal cancer [published correction appears in Surg Today. 2020;50(1):12-20. https://doi.org/10.1007/s00595-019-01878-7
Peng J, Kukar M, Mann G, et al. Minimally Invasive Esophageal Cancer Surgery. Surgical oncology clinics of North America. 2019;28(2):177-200. Disponible en: https://doi.org/10.1016/j. soc.2018.11.009
Xing H, Hu M, Wang Z, et al. Shortterm outcomes of Ivor Lewis vs. McKeown esophagectomy: A meta-analysis. Front. Surg. 2022;9:950108. Disponible en: https://doi.org/10.3389/fsurg.2022.950108
Zhang T, Hou X, Li Y, et al. Effectiveness and safety of minimally invasive Ivor Lewis and McKeown esophagectomy in Chinese patients with stage IA–IIIB esophageal squamous cell cancer: a multicentre, non-interventional and observational study. Interact Cardio Vasc Thorac Surg. 2020;30(6):812- 819. Disponible en: https://doi.org/10.1093/icvts/ivaa038
Takahashi C, Shridhar R, Huston J, et al. Comparative outcomes of transthoracic versus transhiatal esophagectomy. Surgery. 2021;170(1):263-270. Disponible en: https://doi.org/ 10.1186/s12893-022-01875-7
Soltani E, Mahmoodzadeh H, Jabbari Nooghabi A, et al. Transhiatal versus transthoracic esophagectomy for esophageal SCC: outcomes and complications. J Cardiothorac Surg. 2022;17(1):150. Disponible en: https://doi.org/10.1186/s13019-022-01912-9
Ohkura Y, Shindoh J, Ichikura K, et al. Perioperative risk factors of psychological distress in patients undergoing treatment for esophageal cancer. World J Surg Oncol. 2020;18(1):326. Disponible en: https://doi.org/10.1186/s12957-020-02092-3
D’Journo XB, Boulate D, Fourdrain A, et al. Risk Prediction Model of 90-Day Mortality After Esophagectomy for Cancer. JAMA Surg. 2021;156(9):836-845. Disponible en: https://doi. org/10.1001/jamasurg.2021.2376
Watanabe M, Toh Y, Ishihara R, et al. Comprehensive registry of esophageal cancer in Japan, 2015. Esophagus. 2023;20(1):1- 28. Disponible en: https://doi.org/10.1007/s10388-022-00950-5
López P, Alberdi N, Fuertes I, et al. An updated review of the TNM classification system for cancer of the oesophagus and its complications. Radiologia (Engl Ed). 2021;63(5):445-455. Disponible en: https://doi.org/10.1016/j.rxeng.2020.09.004
Published
Issue
Section
License
Copyright (c) 2025 Revista Médica del Instituto Mexicano del Seguro Social
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.
