Circumferential distribution and clinical characteristics of esophageal cancer in lower esophagus: differences related to histological subtype

• Published in: Esophagus : official journal of the Japan Esophageal Society Vol. 16; no. 1; pp. 98 - 106
• Main Authors: Okada, Mayumi, Ishimura, Norihisa, Mikami, Hironobu, Okimoto, Eiko, Oshima, Naoki, Miyaoka, Youichi, Fujishiro, Hirofumi, Ishihara, Shunji, Kinoshita, Yoshikazu
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.01.2019; Springer Nature B.V
• Subjects: Adenocarcinoma - etiology; Adenocarcinoma - pathology; Adult; Aged; Aged, 80 and over; Barrett Esophagus - etiology; Barrett Esophagus - pathology; Endoscopy; Esophageal cancer; Esophageal Neoplasms - etiology; Esophageal Neoplasms - pathology; Esophagitis, Peptic - complications; Esophagoscopy; Esophagus; Female; Gastritis, Atrophic - complications; Gastroenterology; Gastroesophageal reflux; Humans; Male; Medical diagnosis; Medicine; Medicine & Public Health; Middle Aged; Original Article; Precancerous Conditions - etiology; Precancerous Conditions - pathology; Retrospective Studies; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - etiology; Squamous Cell Carcinoma of Head and Neck - pathology; Surgical Oncology; Thoracic Surgery; Barrett’s esophagus; Esophageal squamous cell carcinoma; Esophageal adenocarcinoma; Esophageal cancer
• ISSN: 1612-9059; 1612-9067; 1612-9067
• DOI: 10.1007/s10388-018-0639-3

Background Esophageal adenocarcinoma (EAC) is frequently found on the right-anterior wall of the distal esophagus in short-segment Barrett’s esophagus (SSBE) patients. However, the endoscopic characteristics of EAC in cases with long-segment BE (LSBE) and squamous cell carcinoma (ESCC) in the lower esophagus remain to be fully evaluated. Here, we determined the circumferential distribution and clinical characteristics of esophageal cancer occurring in the lower esophagus based on histological subtype. Methods We retrospectively reviewed the medical records of 150 patients with esophageal cancer (ESCC, n  = 100; EAC, n  = 50) diagnosed at our hospital or a related facility between January 2002 and June 2017, including information regarding endoscopic findings, etiology, and clinical parameters. Results Of the 100 patients with ESCC, 28 lesions were located in the lower esophagus, though characteristic circumferential distribution was not seen regardless of location. Those showed a greater frequency of smoking and drinking habit and gastric mucosal atrophy as compared to patients with EAC. Consistent with the previous reports, EAC in SSBE ( n  = 41) was frequently located on the right-anterior wall. Likewise, EAC at the esophagogastric junction (EGJ) in LSBE was frequently located on the right-anterior wall, while EAC distant from the EGJ showed no characteristic circumferential distribution. Conclusion Our results showed no circumferential predilection for ESCC in the lower esophagus, suggesting that development of this type of lesion may be less affected by gastroesophageal reflux. In addition, EAC at the EGJ was frequently found on the right-anterior wall irrespective of BE length.