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Epidemiological Trend of Esophageal Cancer at a Tertiary Cancer Center in Mumbai, India, Over the Past 15 Years

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Abstract

Background

In developed countries, there has been a definite change in the histopathological spectrum of esophageal cancer towards adenocarcinoma. There are limited data from India regarding the histopathological profile of patients with esophageal cancer.

Materials and Methods

We retrospectively evaluated patients with histologically proven esophageal cancer who were registered at the Tata Memorial Hospital (Mumbai, India) between 2003 and 2018. The primary aim of the study was to analyze the time-trend of the histological pattern of esophageal cancer. Our secondary objectives included evaluating whether there was any correlation between the histology of the esophageal cancer and the age, sex, socioeconomic status (the paying ability of the patient, which was reflected in the treatment category of the patient, i.e., private [full payment], general [subsidized payment], or no charge), comorbidities, and a history of substance abuse.

Results

Among 7874 patients with esophageal cancer, 5092 (64.7%) were men, with a male-to-female ratio of 1.8:1. The median age was 57 years (IQR, 50–65). Of the 4912 patients in whom a history of tobacco or alcohol use had been elicited, 1360 (27.7%) had no history of substance abuse. A majority of the tumors (2942, 37.4%) originated in the middle-third of the esophagus. Squamous cell carcinoma was the predominant histological type, noted in 6413 (81.4%) patients and remained the most common histologic type consistently through the study with no evidence of a time-trend in the histological pattern. On the multivariate analysis, female sex and a history of substance abuse were associated with higher odds of squamous cell carcinoma, while the presence of comorbidities and lower esophageal/gastroesophageal junction primaries were associated with higher odds of adenocarcinoma.

Conclusions

There is no evidence of an epidemiological shift in the histopathologic spectrum of esophageal cancer in India over the last two decades. Four out of five Indian patients with esophageal cancer have squamous cell histology, with the commonest site of origin being the middle third. This is important to recognize, given the varying molecular spectrum and efficacy of therapeutic modalities based on histopathology.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

All authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Author notes

  1. Vanita Noronha and Anbarasan Sekar contributed equally and should be considered equal first authors.

Authors and Affiliations

  1. Department of Medical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India

    Vanita Noronha, Anbarasan Sekar, Akhil Rajendra, Vijay Patil, Nandini Menon, Sunil Chopade, Ajay Kumar Singh, Shripad Banavali & Kumar Prabhash

  2. Department of Pathology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India

    Rajiv Kumar Kaushal

  3. Department of Radiodiagnosis, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India

    Abhishek Mahajan & Amit Janu

  4. Department of Nuclear Medicine, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India

    Nilendu Purandare

  5. Department of Epidemiology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India

    Rajesh Dikshit

  6. Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India

    Rajendra Badwe

  7. Department of Biostatistics, Tata Memorial Hospital, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India

    Smruti Mokal

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Vanita Noronha, Anbarasan Sekhar, Akhil Rajendra, and Smruti Mokal. The first draft of the manuscript was written by Anbarasan Sekhar and Vanita Noronha, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kumar Prabhash.

Ethics declarations

Ethics Approval and Consent to Participate

The study was performed in line with the principles of the Declaration of Helsinki. Deidentified clinicodemographic details were analyzed, hence ethical clearance was not sought.

Competing Interests

Vanita Noronha (all payments made to the institution). Research Funding: Sanofi/Aventis, Dr. Reddy's Laboratories, Intas, AstraZeneca. Travel, Accommodations, Expenses: American Society of Clinical Oncology. Vijay Patil (all payments made to the institution). Research Funding: Johnson & Johnson/Janssen, AstraZeneca, Intas, NATCO Pharma, Eisai Germany, Novartis. Kumar Prabhash (all payments made to the institution). Research Funding: Biocon, Dr Reddy's Laboratories, Fresenius Kabi, AIkem Laboratories, NATCO Pharma, BDR Pharmaceutics, Roche. No other potential conflicts of interest were reported.

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Noronha, V., Sekar, A., Rajendra, A. et al. Epidemiological Trend of Esophageal Cancer at a Tertiary Cancer Center in Mumbai, India, Over the Past 15 Years. J Gastrointest Canc 54, 903–912 (2023). https://doi.org/10.1007/s12029-022-00887-z

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