Clinicopathologic characteristics of esophageal cancer patients in northwest Iran--very low incidence of adenocarcinomas.

ABSTRACT

AIMS: Iran is one of the known countries with a high incidence of esophageal cancer in Asia .We have recently shown that the incidence of Barrett's esophagus, a precancerous lesion for esophageal adenocarcinoma (AC) is very low in the northwest of the country. Therefore, we hypothesized that esophageal AC would also be lower than in the Western world. The aim of this study was to assess the clinicopathologic characteristics of esophageal cancer in comparison the data from western populations. METHODS: This mixed (prospective-retrospective) study enrolled 350 consecutive patients with esophageal cancers (216 endoscopically and pathologically documented, including 134 surgically proven cases) from May 2000 to May 2006, in our referral center in Tabriz, in the northwest of Iran. We localized the tumors in esophagus and esophago-gastric junction. Type III gastric cardial cancers were excluded. RESULTS: The mean age of the patients was 61+/-12.36 (min 16, max 83). The male to female ratio was almost equal (51.7% vs 48.3%). The lower third of the esophagus was involved in 62% of the patients and esophageal ACs accounted for 18.9% of the cases. However, distinct esophageal adenocarcinomas was only seen in two and in the remainder gastric cardia was also involved. SCC was more frequent in females, and adenocarcinoma in males (x 2=8.89, df=2, p=0.012. Among 134 operated cases, resection was feasible in 74.6%. CONCLUSION: In this Iranian population, the incidence of esophageal adenocarcinoma is very much lower than in Western countries.