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Clinicopathological study of multiple superficial oesophageal carcinoma
A Kanamoto1, H Yamaguchi, Y Nakanishi
1Departments of Internal Medicine and Surgery, National Cancer Center Hospital and Pathology Division, National Cancer Center Research Institute, Tokyo, Japan.
Background:
Recently, the diagnosis of superficial oesophageal carcinoma has increased markedly in Japan as a result of advances in endoscopy. A number of these carcinomas have proved to be multiple.
Methods:
Some 359 patients with superficial squamous cell carcinoma of the oesophagus who underwent oesophagectomy (n = 276) or endoscopic mucosal resection (EMR) (n = 83) were reviewed retrospectively. The clinicopathological features of patients with multiple superficial oesophageal carcinoma were compared with those of patients with a single superficial oesophageal carcinoma.
Results:
Of the 359 patients, 99 (28 per cent) had multiple superficial oesophageal carcinoma. The male : female ratio in patients with multiple carcinoma was 98 : 1, compared with 5.3 : 1 for those with a single carcinoma (n = 260) (P = 0.0001). The incidence of tobacco and alcohol use was significantly higher in the patients with multiple carcinoma than in those with a single carcinoma (P = 0.04 and P = 0.03 respectively). The incidence of pharyngeal malignancy was also significantly higher in patients with multiple carcinoma (P = 0.02).
Conclusion:
The high incidence of multiple superficial oesophageal carcinoma indicates a need for careful evaluation of the oesophagus at the time of initial diagnosis, treatment and follow-up for superficial oesophageal carcinoma. Male sex, smoking, alcohol use and the presence of pharnygeal malignancy are high-risk factors for multiple superficial oesophageal carcinoma.
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