Esophageal carcinoma in Southern Thailand.

BACKGROUND: Southern Thailand is an area with a high frequency of esophageal carcinoma. This paper presents basic data regarding esophageal carcinoma patients from this region. METHODS: Patients with histopathological confirmed esophageal carcinoma were retrospectively reviewed. The age, sex, location of tumor and resectability were studied. RESULTS: A total of 813 cases of esophageal carcinoma were reviewed, male:female ratio was 3.54:1 (634:179). Average age in males was 64.62 years and 64.30 years in females. The peak age-incidence was 51-70 years. Squamous cell carcinoma was most commonly found in the mid thoracic portion of the esophagus with 369 cases (45.39%), 70 cases (8.61%) were found in the cervical portion of the esophagus. Adenocarcinoma cancer was found at the esophagogastric junction in 47 cases (5.78%). Only 293 cases (36.04%) were operable. Respiratory tract involvement was noted in 49 cases. CONCLUSION: The most common type of esophageal cancer in Southern Thailand is squamous cell carcinoma, as in other countries in Asia. The status of the patients, advanced age and locally advanced tumor were major factors of our low operable rate.

Chemical components of gallstone in southern Thailand.

The gallstones from 55 patients in Southern Thailand were analyzed to disclose the chemical components using infrared grating spectrophotometry. The main components were calcium bilirubinate, calcium phosphate, calcium carbonate, choleterol and protein inproportions 52.6, 5.5, 5.5, 30.9 and 5.5 per cent of stones, respectively. These proportions are not different from those of gallstones in the northern or central regions of Thailand.

Experience with oesophageal carcinoma in Songklanagarind Hospital.

Clinical data from 175 patients with squamous cell carcinoma of the oesophagus or cardia admitted to Songklanagarind Hospital between 1982 and 1988 were analysed to evaluate the effects on survival of various tumour and treatment variables. Most tumours (greater than = 86%) were in stage III or IV. Forty-seven percent of stage-IV tumours and 99 per cent of those in stages I, II or III were resectable. One-year and 3-year survival rates of resected stage-III patients (57.3% and 27.5%) were significantly higher than those of resected stage-IV patients (33.3% and 0%). Resection conferred no benefit over radiotherapy chemotherapy or no treatment on the survival of stage-IV cases beyond one year. Combined chemotherapy/radiotherapy/resection of stage-III and stage-IV patients gave no statistically significant improvement in survival. Among resected patients, only lymph node involvement was associated with significantly lower survival (relative risk compared to no involvement = 2.3, 95% CL: 1.2, 4.6), while the fungating type of tumour was possibly associated with improved survival (relative risk compared with all other types = 0.24, 95% CL: 0.05, 1.1).

Corrosive oesophagitis: Radiological study.

Thirty-six oesophagograms of 24 patients after ingestion of 75-90% formic acid in suicide attempts were reviewed. AII oesophagograms were obtained in the acute, subacute, and chronic phases. In the acute and suhacute phases, the radiographic findings consisted of mucosal oedema, submucosal oedema or haemorrhages, ulcerations, sloughing of the moucosa, atony and dilatiation. Stricture of the oesophsgus was present in the chronic phase. The severity of the corrosive oesophagitis was considerably related to the concentration, amount, and duration of contact between the caustic agent and the oesophageal mucosa.

Corrosive oesophagitis after formic acid ingestion.

The occurrence of corrosive oesophagitis following ingestion of formic acid has been studied. Twelve patients with this condition were seen by the authors in Songklanagarind Hospital during the three years period, January 1983 to December 1985. The sex ratio, male: female was 1 : 5. The ingestion of formic acid was due to attempted suicide in 83.3% of patients, and accidental in 16.7% of patients. Oesophagoscopy was done in all patients in every case. Pathological changes were seen in the oesophagus, in seven cases also in the stomach, and in one case even in the duodenum. The treatment varied from simple oesophageal dilatation in mild cases to surgical intervention in the more severe cases. The mean length of stay in hospital was 36.5 days (3-60 days). Postoperative complications occurred in 3 patients in 3 patients and 2 patients died.