Oesophageal carcinoma: endoscopic and clinical findings in 258 patients

During the 10-year period 1971-1980, oesophagoscopy was carried out on a total of 3235 patients in the Department of Otolaryngology, Turku University Central Hospital, Finland. Oesophageal carcinoma was diagnosed in 258 patients, 113 (44 per cent) men and 145 (56 per cent) women. The diagnosis was verified in 228 cases (88.4 per cent) by using an optical rigid oesophagoscope and in 30 cases (11.6 per cent) by a fibreoptic endoscope. The most common and earliest symptom was difficulty in swallowing in 50 per cent of cases. In 44 per cent of patients the symptoms persisted over six months before diagnosis. Upper and middle thoracic portions of the oesophagus were the sites of origin of the carcinoma in 57 per cent of the patients. The macroscopic picture obtained by oesophagoscopy was regarded as malignant in 83 per cent of patients and extraoesophageal spread of the tumour was estimated to be present in 48 per cent of patients by the time of diagnosis. Histological studies showed the tumour to be squamous cell carcinoma in 62 per cent of patients and in 24 per cent well differentiated. Squamous cell carcinoma was seen more often in men than in women. In patients with carcinoma in situ, alcohol and tobacco were regarded as aetiological factors in 53 per cent of cases. The need for repeated oesophagoscopy in patients with symptoms related to swallowing is stressed.