engleski

Esophageal adenocarcinoma in patient younger than 45 Years: experience from a tertiary care center in Croatia.

According to the data obtained from the Croatian National Cancer Registry for 2014, there were 168 new cases of the esophageal cancer in the male and 28 new cases in the female population. The trends in esophageal cancer still display an increase in the standardized rates of incidence and mortality. At the time of primary diagnosis 25.3 % of patients have positive regional lymph nodes, 11.7 % of patients have evidence of distant metastases and 53.6 % of patients have unknown stage. A 42-year-old man with a past medical history of chronic gastritis presented initially with symptoms of early satiety, dysphagia to solids, and a 33-pound weight loss over the past 2 months. He has a 30-pack year history of smoking. There is no family history of cancer. On physical exam, his vitals were stable and his exam was pertinent for cachexia. The laboratory analysis showed no remarkable abnormalities, including serum tumor markers. Due to his complaints, esophagogastroduodenoscopy (EGD) was done and detected the infiltration into the distal part of esophagus, which was histopathologically confirmed as adenocarcinoma of esophagus. A barium swallow confirmed a luminal narrowing of the distal esophagus for about 5 cm. Further staging was performed with computed tomography (CT) of the chest, abdomen, and pelvis. CT scan of the abdomen and pelvis revealed lymphadenopathy most prominent in the hepatogastric ligament measuring up to 1.5 × 1.5 cm. Multidisciplinary tumour board decided to start with chemoradiation followed by surgery. The results of two meta-analyses have shown that preoperative chemoradiation therapy plus surgery significantly reduced 3-year mortality and locoregional recurrence, and preoperative chemoradiation therapy also downstaged the tumor when compared with surgery alone. Patients are treated somewhat differently in different regions of the world and survival rates remain far from being satisfactory. The fforts to further improve outcome are highly warranted.

esophageal cancer ; adenocarcinoma ; chemoirradiation ; survival

nije evidentirano