Volume : IX, Issue : VI, June - 2019

STAGE AT THE TIME OF TREATMENT IN CANCER OESOPHAGUS: PRESENTATION DELAY

Dr. Varsha Mandloi, Dr. Abhishek Shrivastava, Dr. Neeraj Chhari, Dr. Ram Singh Jamre

Abstract :

INTRODUCTION: Esophageal cancer is a highly virulent disease with an aggressive clinical course with a case fatality of 90%. It is an endemic in many part of the world, particularly in the developing nations. Esophageal cancer shows one of the widest geographical variations among all malignancies and is the eighth most common cancer world–wide. Dysphagia is the cardinal symptom of oesophageal cancer yet many patients present late. There is only 14% five year survival despite recent advances in the treatment techniques. A few months delay before final treatment may have an impact on the stage of cancer and thereby on patient’s prognosis. OBJECTIVE: The primary aim of this study was to analyse the time delay from the first symptom to treatment in oesophageal cancer and to analyse the relationship between the delay and stage at the time of definitive treatment. MATERIAL AND METHODS: 50 patients were analysed retrospectively and prospectively between July 2014 and December2015 at Gandhi Medical College Bhopal. Patients were interviewed at their first presentation to our hospital. Dates were recorded according to the patient’s recollection, written information in the doctor’s records during diagnosis process, and the hospital files. Details from the patient’s first symptoms and course of diagnosis and treatment were recorded. The overall delay in months was recorded from appearance of the first symptoms to the date when the patient was started with definitive cancer specific treatment (end point), and this delay was divided as : (1) time of appearance of the first symptom to first contacting the health care system (patient delay). (2) Time from first contacting the healthcare system to histopathological diagnosis (histopathological delay). (3) Time from histopathological diagnosis to the end point (treatment delay). Statistical analysis: Data analysed using SPSS ver. 16(SPSS Inc., Chicago, Ill., USA). RESULTS: The median age of presentation was 54.6yrs .The first symptoms were progressive dysphagia in all the patients (100%), abdominal or chest pain, regurgitation and odynophagia. The mean delay from first symptom to end point was 360.4 days. Total symptom– to–treatment was due to: patient delay (86%) – histopathological delay (5.3%) treatment delay (8.7%). CONCLUSION: Duration of delay is very long in patients. Most of the cases presents at advanced stage of disease. Patient delay is the most important factor, community education programs may help in their early presentation to the hospital for better QOL.

Keywords :

Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

STAGE AT THE TIME OF TREATMENT IN CANCER OESOPHAGUS: PRESENTATION DELAY, Dr. Varsha Mandloi, Dr. Abhishek Shrivastava, Dr. Neeraj Chhari, Dr. Ram Singh Jamre INDIAN JOURNAL OF APPLIED RESEARCH : Volume-9 | Issue-6 | June-2019

Number of Downloads : 261

References :