Cancer de l’?sophage au Sénégal: revue d’une série de 72 cas

Aim

The cancer of the oesophagus because of its poor prognosis is a terrifying digestive tumour. The goal of this work was to appreciate the epidemiologic characteristics, anatomo-clinics and to become it of a series of patients.

Patients and methods

It was about a retrospective analysis of 72 records of patients in the same team, followed between January 2004 and December 2007.

Results

Squamous cell carcinoma accounted for 94.4% of cancers of the oesophagus during this period. The average age of the patients was 48 years with extremes of 16 and 86 years. The diagnosis was late with six months average time of the clinical symptomatology evolution. The general state was faded with an index of performance WHO superior to 2 at 48.6% of the patients. The high alcohol consumption and smoking, principal exogenic toxic factors risk was found only in 16.6% of the cases. Achalasia and Plummer-Vinson syndrome, squamous cell carcinoma specific factors of risk, were present in 5.6% of the cases. Gastrointestinal oesophageal reflux disease, indirect risk factor of adenocarcinoma, was found in 9.7% of the cases. The disease was advanced with 64% of stages III and IV TNM in classification (UICC 2002). The rate of resecablity was 27.8%. None of our patients had profited from neo-adjuvant treatment. Overall survival at two years was estimated at 2.8%.

Conclusion

The pejorative prognosis seemed to be raised by the late diagnosis in our series. An improvement of survival would pass by an early detection. A barium transit in front of all odynophagia, followed by an endoscopic examination if required must be our standard. The mechanism of the viral carcinogenesis by human papillomavirus types 16 and 18 evoked but not completely elucidated is a way of research to decrease the incidence of the cancer of the oesophagus in population exposed to these viruses.