Anzures LME, Pineda CBE, Espino CH, Rodríguez LL

Language: Spanish
References: 9
Page: 11-15
PDF size: 49.10 Kb.

ABSTRACT

The world statistics about the frequency of cancer in general, cancer of the digestive system, esophagical cancer and the figures of the esophagical cancer in Mexico were reviewed. Material and methods. 167 histologically verified cases of esophagic cancer were studied from those admitted at the Gastroenterology Service of the General Hospital of México. The variables studied wore: 1. compared frequency; 2. sex and groups of age; 3. Nutrition antecedents, smoking and alcoholic habits; 4. Time elapsed since the beginning of symptomatology and the first medical consultation and from that one to the certainty of diagnosis; 5. Location affected; 6. Histological variety; 7. Stadification (TNM) and; 8. Treatment. Results and conclusions: The esophagical cancer took the 2nd place at the Service of Gastroenterology of the General Hospital of México among the neoplasic pathology of the digestive system. 70.1% was seen in men and 29.9% in women with a ratio of 2.3:1. The diet was insufficient in more than one half of men and in a third of the women. Alcoholism was positive in 76.5% of men and 53% of women. Smoking was positive in 61% of men and 28.2% of women. Only a fifth of patients showed up a month after the symptomatology started and about 49% came before six months. The diagnosis was made of certainty in 60% of cases in less than a month after the first consultation due to opportunity to perform endoscopies. The most frequent location was the esophago-gastric union (29.3%) followed by the midle third (26.9%), the distal third (20.4%) and the proximal only 12.6%. Out of all the cases we found 106 adenocarcinomas and 61 epidermoid carcinomas. 11% were in Stade I or II, the 50% in III and 39% in Stade IV. Treatment: 17 cases were submitted to oesophagic resection and colon transposition to keep the oro-gastric transit. 106 were cases of some kind of gastrostomy, 50 out of them received besides radiotherapy. 7 cases got rigid prosthesis by endoscopic way in 24 the tumoral lisis with absolute alcohol was done. The oesophagoplasty with right or left colon rehabilitate completely the oesophagectomised patient. The technology progress allows to do a certainty diagnostic and gives several options of treatments to palliate as the endoscopic gastrostomy rigid prosthesis placement and lisis with absolute alcohol.

REFERENCES

1. Garza J. Cáncer del esófago. Tesis recepcional. Facultad de Medicina, Universidad Nacional de México, 1928.

2. Villalobos JJ. Cáncer del aparato digestivo. Gaceta Med Mex 1977; 113:273-277.

3. Cáncer Incidence in Five Continents. Vol VI. No. 120. Lyon, 1992. IARC.

4. INEGI. Lista básica de defunciones 1995. México: INEGI, 1995.

5. Dirección General de Epidemiología. Registro Histopatológico de las Neoplasias Malignas, 1993-1995. México: SSA.

6. Anzures ME, Tinajero R, Rodríguez L, Almeida J. Cáncer del esófago. Gaceta Med Mex 1977; 113: 275-277.

7. Anzures ME, Garza V. Esofagoplastia con colon derecho. Rev Med Hosp Gral 1959; 22:43-65.

8. Rodríguez L. Factores que retrasan el diagnóstico temprano del cáncer gastrointestinal. Rev Gas Mex 1988; 53: 4.

9. Espino H, Valdés R, Bernal F. Necrosis tumoral con etanol absoluto en el tratamiento de la disfagia por cáncer. Endoscopia 1997; 9: 43-48.