Annals of Surgical Oncology

, Volume 22, Issue 1, pp 311–315 | Cite as

Clinicopathological Characteristics of Esophageal Squamous Cell Carcinoma in Patients Younger Than 50 years

  • Yuta Kasagi
  • Masaru Morita
  • Hajime Otsu
  • Hiroyuki Kawano
  • Koji Ando
  • Yukiharu Hiyoshi
  • Shuhei Ito
  • Yuji Miyamoto
  • Hiroshi Saeki
  • Eiji Oki
  • Yoshihiko Maehara
Thoracic Oncology



This study clarifies age differences in clinicopathologic characteristics and risk factor exposure of patients who have undergone esophagectomy for esophageal cancer (EC).


Clinical results of esophagectomy were compared between 22 patients younger than 50 years of age (Group I) and 327 patients older than 50 years of age (Group II) with esophageal squamous cell carcinoma.


The two groups did not significantly differ in clinicopathological characteristics, including prognosis. Postoperative pulmonary complication incidence rates were 4.2 % (Group I) and 14.4 % (Group II). In Group I, the incidence of multiple ECs was 36.4 %, and association with head and neck cancer was 31.8 %, which were significantly higher than in Group II (13.4 %, p = 0.021; and 9.2 %, p = 0.015, respectively). Furthermore, the patients in Group I with multiple cancers were almost all heavy smokers and/or users of alcohol.


These results suggest that multiple upper aerodigestive tract cancers are associated with heavy exposure to risk factors in patients younger than 50 years of age.


Esophageal Cancer Esophageal Squamous Cell Carcinoma Heavy Smoker Postoperative Pulmonary Complication Electronic Supplementary Table 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank the Edanz Group Japan (Fukuoka, Japan) for their editorial assistance.

Conflict of interest

Yuta Kasagi, Masaru Morita, Hajime Otsu, Hiroyuki Kawano, Koji Ando, Yukiharu Hiyoshi, Shuhei Ito, Yuji Miyamoto, Hiroshi Saeki, Eiji Oki, and Yoshihiko Maehara declare no conflicts of interest.

Supplementary material

10434_2014_3856_MOESM1_ESM.docx (68 kb)
Supplementary material 1 (DOCX 67 kb)


  1. 1.
    Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–917.PubMedCrossRefGoogle Scholar
  2. 2.
    Morita M, Yoshida R, Ikeda K, et al. Advances in esophageal cancer surgery in Japan: an analysis of 1,000 consecutive patients treated at a single institute. Surgery. 2008;143:499–508.PubMedCrossRefGoogle Scholar
  3. 3.
    Morita M, Nakanoko T, Fujinaka Y, et al. In-hospital mortality after a surgical resection for esophageal cancer: analyses of the associated factors and historical changes. Ann Surg Oncol. 2011;18:1757–65.PubMedCrossRefGoogle Scholar
  4. 4.
    Morita M, Egashira A, Yoshida R, et al. Esophagectomy in patients 80 years of age and older with carcinoma of the thoracic esophagus. J Gastroenterol. 2008:43:345–51.PubMedCrossRefGoogle Scholar
  5. 5.
    Tachimori Y, Ozawa S, Fujishiro M, et al. Comprehensive registry of esophageal cancer in Japan, 2006. Tokyo: The Japan Esophageal Society; 2013: pp. 4–12.Google Scholar
  6. 6.
    van Nistelrooij AM, Andrinopoulou ER, van Lanschot JJ, Tilanus HW, Wijnhoven BP. Influence of young age on outcome after esophagectomy for cancer. World J Surg. 2012;36:2612–21.PubMedCrossRefGoogle Scholar
  7. 7.
    Donohoe CL, Gillycuddy EM, Reynolds V. The impact of young age on outcome inesophageal and junctional cancer. Dis Esophagus. 2011;24:560–568.PubMedCrossRefGoogle Scholar
  8. 8.
    Hamouda A, Forshaw M, Rohatgi A, Mirnezami R, Botha A, Mason R. Presentation and survival of operable esophageal cancer in patients 55 years of age and below. World J Surg. 2010;34:744–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Patil PK, Patel SG, Mistry RC, Deshpande RK, Desai PB. Cancer of the esophagus in young adults. J Surg Oncol. 1992;50:179–82.PubMedCrossRefGoogle Scholar
  10. 10.
    Portale G, Peters JH, Hsieh CC, et al. Esophageal adenocarcinoma in patients <or = 50 years old: delayed diagnosis and advanced disease at presentation. Am Surg. 2004;70: 954–8.PubMedGoogle Scholar
  11. 11.
    Mehta SP, Bailey D, Davies N. Comparative outcome of oesophagogastric cancer in younger patients. Ann R Coll Surg Engl. 2010;92:515–8.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Hashemi N, Loren D, DiMarino A, Cohen S. Presentation and prognosis of esophageal adenocarcinoma in patients below age 50. Dig Dis Sci. 2009;54:1708–12.PubMedCrossRefGoogle Scholar
  13. 13.
    Morita M, Araki K, Saeki H, et al. Risk factors for multicentric occurrence of carcinoma in the upper aerodigestive tract: analysis with a serial histologic evaluation of the whole resected-esophagus including carcinoma. J Surg Oncol. 2003;83:216–21.PubMedCrossRefGoogle Scholar
  14. 14.
    Morita M, Kumashiro R, Kubo N, et al. Alcohol drinking, cigarette smoking, and the development of squamous cell carcinoma of the esophagus: epidemiology, clinical findings, and prevention. Int J Clin Oncol. 2010;15:126–34.PubMedCrossRefGoogle Scholar
  15. 15.
    Kuwano H, Nismura N, Ohtsu A, et al.; Japan Esophageal Society. Guidelines for diagnosis and treatment of carcinoma of the esophagus, April 2007 edition: part II. Edited by the Japan Esophageal Society. Esophagus. 2008;5:117–32.CrossRefGoogle Scholar
  16. 16.
    Morita M, Kuwano H, Ohno S, et al. Multiple occurrence of carcinoma in the upper aerodigestive tract associated with esophageal cancer: reference to smoking, drinking and family history. Int J Cancer. 1994;58:207–10.PubMedCrossRefGoogle Scholar
  17. 17.
    Cook MB, Chow WH, Devesa SS. Oesophageal cancer incidence in the United States by race, sex, and histologic type, 1977–2005. Br J Cancer. 2009;101:855–59.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Tsai CH, Hsu HS, Wang LS, et al. Surgical results of squamous cell carcinoma of esophagus in young patients. J Chin Med Assoc. 2003;66:288–93.PubMedGoogle Scholar
  19. 19.
    Lee CH, Lee KW, Fang FM, et al. The use of tobacco-free betal-quid in conjunction with alcohol/tobacco impacts early-onset age carcinoma distribution for upper aerodigestive tract cancer. J Oral Pathol Med. 2011;40:684–92.PubMedCrossRefGoogle Scholar
  20. 20.
    Saeki H, Ohno S, Araki K, et al. Alcohol consumption and cigarette smoking in relation to high frequency of p53 protein accumulation in esophageal squamous cell carcinoma in the Japanese. Br J Cancer. 2000;82:1892–4.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Morita M, Mimori K, Shiraishi T, et al. Altered expression of FHIT in carcinoma and precarcinomatous lesions of the esophagus. Cancer Res. 2000;60:1177–82.Google Scholar
  22. 22.
    Morita M, Oyama T, Nakata S, et al. Expression of FHIT in esophageal epithelium and carcinoma: reference to drinking, multicentric carcinogenesis. Anticancer Res. 2006;26: 2243–8.PubMedGoogle Scholar
  23. 23.
    Ito S, Ohga T, Saeki H, et al. p53 mutation profiling of multiple esophageal carcinoma using laser capture microdissection to demonstrate field carcinogenesis. Int J Cancer. 2005;113: 22–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Osta EH, Falchook G, Tsimberidou A, et al. BRAF mutations in advanced cancers: clinical characteristics and outcomes. Plos One. 2011;6(10): e25806.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Wu IC, Zhao Y, Zhai R, et al. Association between polymorphisms in cancer-related genes and early onset of esophageal adenocarcinoma. Neoplasia. 2011;13:386–92.PubMedCentralPubMedGoogle Scholar
  26. 26.
    Galeone C, Pelucchi C, Levi F, et al. Folate intake and squamous-cell carcinoma of the oesophagus in Italian and Swiss men. Ann Oncol. 2006;17:521–5.PubMedCrossRefGoogle Scholar
  27. 27.
    Macfarlane TV, Macfarlane GJ, Oliver RJ, et al. The aetiology of upper aerodigestive tract cancers among young adults in Europe: the ARCAGE study. Cancer Causes Control. 2012;21:2213–21.CrossRefGoogle Scholar
  28. 28.
    Dawsey SP, Tonui S, Parker RK, et al. Esophageal cancer in young people: a case series of 109 cases and review of the literature. Plos One. 2010;5(11):e14080.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Yuta Kasagi
    • 1
  • Masaru Morita
    • 1
  • Hajime Otsu
    • 1
  • Hiroyuki Kawano
    • 1
  • Koji Ando
    • 1
  • Yukiharu Hiyoshi
    • 1
  • Shuhei Ito
    • 1
  • Yuji Miyamoto
    • 1
  • Hiroshi Saeki
    • 1
  • Eiji Oki
    • 1
  • Yoshihiko Maehara
    • 1
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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