Cancer of the esophagus in young adults

Clinicopathological features and survival data of squamous cell carcinoma of the esophagus were analyzed from the viewpoint of age differences in 453 patients treated at the Tata Memorial Hospital, Bombay, India. Two groups were studied: group A, aged 35 years or less; and group B, aged above 35 years. There was no significant difference among the two groups with regard to sex distribution, site and length of the tumor, operability, morphology, histological grade, vascular and lymphatic invasion, and lymph node metastasis. The primary lesion was more advanced and the rate of incomplete resections was higher in younger patients. The incidence of cardiopulmonary complications and postoperative deaths was significantly lower in younger patients. Recurrence of the disease following complete resection was more frequent in the younger age group (chi 2 = 2.61; P = .1063), although the pattern of recurrence remained the same in both groups. Disease-free survival in younger patients following complete resection of the tumor was poorer as compared to the older patients, but the difference is statistically not significant (chi 2 = 1.882; P = .1701). These findings suggest either a delayed diagnosis or a biologically sinister disease in the younger group; further studies of the two groups vis-a-vis their biologic parameters (DNA ploidy, etc.) are in progress and will form the subject of another communication.