Clinicopathological Characteristics of Patients with Cancer Esophagus at a Tertiary Hospital in Sub-Himalayan Region

Introduction: Carcinoma esophagus has heterogeneous and changing epidemiology and clinicopathological characteristics. A thorough literature search revealed a knowledge gap regarding esophageal cancers in this sub-Himalayan region. Materials and Methods: This prospective, descriptive, observational study was conducted at a tertiary institute in the sub-Himalayan region, including 119 patients from January 2021 to December 2022. Patients above 18 years of age with histologically proven cancer esophagus and giving their informed consent were recruited. The aim was to study the clinicopathological characteristics of adult patients with carcinoma esophagus. Descriptive data were collected, and statistical analysis was done using the SPSS version 23 software. Results: The mean age of presentation was 58.55 ± 10.76 years, with the male-to-female ratio of 1.70:1 and rural-to-urban distribution of 2.05:1. Distribution was higher at higher altitudes. The majority of patients consumed large amounts of hot beverages on a regular basis (83.2%). The disease was more common in the lower (V) and upper lower (IV) socioeconomic status. Progressive dysphagia (Grade III to V in 96.6%), loss of appetite, and unintentional significant weight loss were the common presenting symptoms. The most common involved subsite was middle thoracic (53.4%), followed by lower thoracic (40.5%), upper thoracic (28.4%), and cervical esophagus (12.1%). Only 12.6% of patients presented as Stage II, the rest were in a higher stage. All patients were having squamous cell carcinoma except one case (0.8%) of adenocarcinoma and small-cell carcinoma and two cases (1.6%) of NET. The mean primary delay was 1.73 ± 0.90 months, and the mean secondary delay was 1.02 ± 0.77 months. Conclusion: Our results align with the published literature with additional observations of changes in disease distribution with altitudes. However, a following study is required for trend analysis and develop policies for the primary prevention and early detection of carcinoma esophagus.