• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4613-4617
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• 2012

National cancer incidence data were utilized to analyze trends in esophageal cancer incidence in China in order to provide basic information for making cancer control strategy. We retrieved and re-sorted valid esophageal cancer incidence data from National Central Cancer Registry Database over 20 years period from 1989 to 2008. Crude incidence and age-standardized incidence rates were calculated for analysis, with annual percent change estimated by Joinpoint software for long term trend analysis. The crude incidence rate of esophageal cancer was found to have remained relatively stable in both urban and rural areas over the 20 year period. Age standardized incidence rate (ASR) in cancer registration areas decreased from 39.5/100,000 in 1989 to 23.0/100,000 in 2008 in all areas (AAPC=-3.3%, 95% CI:-2.8~-3.7). The trend was no change in urban areas and 2.1% average annual decrease observed in rural aras. Before the year of 2000, esophageal cancer incidence rates significant decreased with 2.8% annually and then the rates kept stable. Over 20 years from 1989 to 2008, esophageal cancer age standardized incidence rate in cancer registration areas decreased with time. However, esophageal cancer is still a big issue and efforts for control should be continuously enhanced. Cancer registration is playing an important role in cancer control with the number of registries increasing and data quality improving in China.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5415-5420
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• 2012

The aim of this study was to investigate QoL (quality of life) of patients with esophageal cancer in northern Henan province, China, and to accurate evaluate and reflect the relationship between patient characteristics and QoL. In the high risk area of esophageal cancer in the north of Henan province, 735 patients with esophageal cancer were investigated. The Eysenck personality questionnaire (EPQ) and QoL were analyzed by using the questionnaire of general situation, EPQ, QLQ-C30 and QLQ-OES18. The effects of personal character on the QoL of esophageal carcinoma patients were analyzed by SPSS 11.0 software. The QoL of esophageal cancer patients in Northern Henan region was significantly affected by character. The difference between choleric and type of melancholic temperament types was significant (P<0.01), also in OESEAT, OESTA, OESCO and OESSP (P<0.05). Differences in personal character can thus influence the quality of esophageal cancer patient lives.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6929-6934
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• 2014

Background: To analyze the mortality distribution of esophageal cancer in China from 1991 to 2012, to forecast the mortality in the future five years, and to provide evidence for prevention and treatment of esophageal cancer. Materials and Methods: Mortality data for esophageal cancer in China from 1991 to 2012 were used to describe its epidemiological characteristics, such as the change of the standardized mortality rate, urban-rural differences, sex and age differences. Trend-surface analysis was used to study the geographical distribution of the mortality. Curve estimation, time series, gray modeling, and joinpoint regression were used to predict the mortality for the next five years in the future. Results: In China, the incidence rate of esophageal cancer from 2007 and the mortality rate of esophageal cancer from 2008 increased yearly, with males at $8.72/10^5$ being higher than females, and the countryside at $15.5/10^5$ being higher than in the city. The mortality rate increased from age 45. Geographical analysis showed the mortality rate increased from southern to eastern China, and from northeast to central China. Conclusions: The incidence rate and the standardized mortality rate of esophageal cancer are rising. The regional disease control for esophageal cancer should be focused on eastern, central and northern regions China, and the key targets for prevention and treatment are rural men more than 45 years old. The mortality of esophageal cancer will rise in the next five years.

• Journal of Chest Surgery
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• v.26 no.3
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• pp.214-218
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• 1993

Extensive lymphnode dissection combined with thoracic esophagectomy improved prognosis of esophageal cancer, but there is still high postoperative recurrence rate. The immunologic capacity of esophageal cancer patients is compromised by surgery and adjuvant chemotherapy. Therefore immunological therapy for esophageal cancer patients seems rational. We have adopted postoperative immunochemotherapy since 1988. From 1988 to 1992, 31 patients with thoracic esophageal cancer underwent esophagectomy and radical lymphnode dissection, and selected patient with early esophageal cancer and unfit for thoracotomy underwent transhiatal esophagectomy in Korea University Hospital. Mean age of patients was 56 years. There were 28 squamous cell cancers, 2 adenocarcinomas and one mixed tumor. There were 4 stage I, 3 stage II, 18 stage III, and 6 stage IV cases. There were no opeartive death. Postoperative complications included anastomotic leakage in 9%, pneumonia 3 %, cylothorax 3%, recurrent laryngeal neve paresis in 3% of all patients. Curative resection group[n=19] received immunotherapy. Noncurative resection group[n=12] received postoperative immunochemotherapy, including PS-K, CDDP, and 5-FU. Operative survivors were followed from 4 months to 5 years. There were 3 lost of follow-up. Actuarial survival rate is 79% to one year, 54% to two years and 27% to five years.In conclusion, an transthoracic esophagectomy combined with systematic lymph node dissection and postoperative immunochemotherapy could improve survival rate for esophageal cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3617-3619
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• 2012

Background: The completeness of cancer registration is a major validity index of any reported cancer incidence. The present study aimed to evaluate the esophageal cancer incidence registered in the Tehran Metropolitan Area Cancer Registry. Materials and methods: The data on esophageal cancer abstracted from three sources of 1) pathology departments, 2) medical records, and 3) death certificates during 2003 till 2007 were utilized. The completeness of the data sources were evaluated using coverage (defined as the proportion of a community population with esophageal cancer identified by the source) and density (defined as the proportion of non-empty fields of the data by source). Results: A total 1,404 cases of esophageal cancer were reported for the duration of the study. Pathology provided 771, medical records 432, and death certificates 609. The coverage was 0.55 for pathology, 0.31 for medical records, and 0.43 for death certificates. The respective density values were 0.82, 0.96 and 0.98, respectively. Pathology (0.45) was the most complete source followed by medical records (0.42), and death certificates (0.29). Discussion: A low degree of completeness dictates putting more effort into case finding plus abstracting data more thoroughly.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2821-2823
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• 2014

Background: Esophageal and gastric cancer generally have a poor prognosis and may share common risk factors. It has been demonstrated that the pesticide usage may contribute to development of many cancer types. In this study, the relation between amount of pesticides used in agriculture and esophageal and gastric cancer incidence was researched. Materials and Methods: Findings from the data bank of the Ministry of Health Provincial Health Directorate Cancer Records Center between the years of 1998-2010 were used. All patients who were diagnosed with gastric and esophageal cancer histopathologically were included. Data for annual pesticide usage were obtained from Provincial Agriculture Directorate for the same time period. Statistical analysis was performed using the Spearman test. Results: One thousand eight hundred and ninety-six patients were involved in the study, 1,233 males (65%) and 663 females (35%), 230 with esophageal cancer (12.1%) and 1,666 with gastric cancer (87.9%). No statistically significant relation was apparent between pesticide amount used and esophageal cancer (p: 0.87). Conclusions: In our study, there was no relationship between pesticide usage and esophageal or gastric cancer. However, the time between pesticide usage and cancer development was not known, qualifying the comparison.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1747-1749
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• 2015

Background: Esophageal cancer is one of the major health concerns in Southeast Asian countries, including Thailand. However, only a limited number of studies have been reported from this region. This study was designed to evaluate the prevalence, clinical characteristics and survival rate of esophageal cancer in Thailand. Materials and Methods: Clinical information, histological features and endoscopic findings were collected from a tertiary care center in central region of Thailand between September 2011- November 2014 and reviewed. Results: A total of 64 esophageal cancer patients including 58 men and 6 women with mean age of 62.6 years were enrolled. Common presenting symptoms were dysphagia (74%), dyspepsia (10%) and hematemesis (8%). Mean duration of symptoms prior to diagnosis was 72 days. Esophageal stenosis with contact bleeding was the most common endoscopic finding (55.6%). The location of cancer was found in proximal (16%), middle (50%) and distal (34%) esophagus. Squamous cell carcinoma was far more common histology than adenocarcinoma (84.2% vs 10.5%). However, esophageal adenocarcinoma was significantly more common than squamous cell carcinoma in distal area of esophagus (100% vs 22.9%; p=0.0001, OR=1.6, 95%CI=1.1-2.2). Esophageal cancer stages 3 and 4 accounted for 35.2% and 59.3% respectively. Overall 2-year survival rate was 20% and only 16% in metastatic patients. Conclusions: Most esophageal cancer patients in Thailand have squamous cell carcinoma and nearly all present at advanced stage with a grave prognosis. Screening of high risk individuals and early detection might be important keys to improve the survival rate and treatment outcome in Thailand.

• Journal of Digestive Cancer Research
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• v.1 no.1
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• pp.17-23
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• 2013

Over the decades, the treatment of the esophageal cancer has been debated. Multimodal therapy is a important keystone in advanced esophageal cancer. Neoadjuvant chemoradiation therapy is now known to provide advantages for treating stage II and stage III esophageal squamous cell cancer and can also be considered for the esophageal adenocarcinoma. Definitive chemoradiation therapy results in long-term survival compared with surgery alone. This review aims to provide recent consensus recommendations based on the data and literatures.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4403-4407
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• 2012

Background: Glutathione-S-Transferase T1 (GSTT1) gene has been shown to be involved in the development of esophageal cancer. However, the results have been inconsistent. In this study, the authors performed a meta-analysis to clarify the association between GSTT1 polymorphism and esophageal cancer risk among Chinese Han population. Methods: Published literature from PubMed, the China National Knowledge Infrastructure and Wanfang Data were searched. Pooled odds ratio (OR) and 95% confidence interval (95%CI) was calculated using a fixed- or random-effects model. Results: Eleven studies with a total of 2779 individuals were included in the meta-analysis. The results showed that GSTT1 null genotype was significantly associated with esophageal cancer risk in Chinese (OR = 1.31, 95%CI 1.12 to 1.53, p = 0.001). Further sensitivity analyses confirmed the significant association. The cumulative meta-analysis showed a trend of an obvious association between GSTT1 null genotype and esophageal cancer risk as information accumulated by year. Conclusions: This meta-analysis suggests a significant association of GSTT1 null genotype with esophageal cancer risk in the Chinese Han population.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10143-10149
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• 2015

Background and Aim: No firm evidence of HPV infection in esophageal cancer has been established to date. The aim of this meta-analysis was to investigate the prevalence of HPV 16 in esophageal cancer in China, which had a high burden of the disease. Materials and Methods: Studies on HPV infection and esophageal cancer were identified and a random-effects model was used to pool the summary prevalence and corresponding 95% confidence intervals (CIs). Results: A total of 3,429 esophageal cancer cases were evaluated from 26 eligible studies in this meta-analysis. The summary estimate for HPV16 prevalence was 0.381 (95% CI: 0.283, 0.479). The prevalence varied by geographical areas of the study, publication year, HPV detection method and types of specimen. In sensitivity analysis, HPV 16 prevalence ranged from 0.368 (95% CI: 0.276, 0.460) to 0.397 (95% CI: 0.286, 0.508). Conclusions: The results indicate a relatively high level of HPV 16 prevalence in esophageal cancer among Chinese population, although there was variation between different variables. Further studies are needed to elucidate the role of HPV in esophageal carcinogenesis with careful consideration of study design and laboratory detection method, providing more accurate assessment of the HPV status in esophageal cancer.