Abstract
Introduction: Esophageal squamous cell carcinoma (ESCC) accounts for 90% of esophageal cancers worldwide but is less common in the developed world. Our aim was to report patient and tumor characteristics of individuals diagnosed with ESCC within the underserved Los Angeles County population. Methods: Review of the hospital pathology database identified 65 cases of patients ages 18-80 with a pathologic diagnosis of ESCC from 2003-2015. A retrospective chart review of electronic health records was conducted excluding patients of unknown ethnicity leaving 61 patients. Patients were characterized by gender, age, alcohol and tobacco use, and family history. Endoscopy and pathology reports were reviewed to confirm tumor location, length, and pathological staging. Frequency counts and percentages were reported for categorical characteristics. A chi-square test or Fisher’s Exact test was performed to assess if characteristic variables differed by ethnicity. Results: Patients identified with ESCC in our cohort were predominantly Hispanic (59%, n=36) and 41% were non-Hispanic (n=10 Asian, n=10 African Americans, and n=5 Caucasian). ESCC was more commonly diagnosed in males vs. females in Hispanics and non-Hispanics (83.3% and 80% vs 16.7% and 20%, p=0.75). Age of diagnosis was between the ages of 18-60 years in nearly 56% and greater than 60 years in 44% of Hispanics and non-Hispanics (p=0.97). Most Hispanics and non-Hispanics had exposure to alcohol (74.1% and 85%, p=0.48) or tobacco (53.9% and 68.2%, p=.31). Most Hispanic and non-Hispanics did not have a family history of cancer (72% and 80%, p=0.73). Tumor location was most often proximal in Hispanic and non-Hispanics (66.7% and 83.3%, p=0.16) and of similar length (p=0.29). Most tumors in both Hispanic and non-Hispanic patients were moderately/poorly differentiated (82.9% and 91.3%, p=0.46). Hispanics were less likely to present with metastatic ESCC as compared to non-Hispanic patients (42.3% vs. 75%, p=0.03). Conclusion: ESCC in both groups within the Los Angeles County population were diagnosed most often in the proximal esophagus of males with history of exposure to alcohol and/or tobacco. Despite similar patient and tumor characteristics, ESCC in Hispanics was less often metastatic at the time of diagnosis compared to non-Hispanics. Despite the small numbers, our study is one of the few to include a large cohort of Hispanics and support further investigation of factors in different ethnicities that may be protective against advanced disease.
Citation Format: Divya Ayyala, Caron Park, Yanling Ma, Gregory Idos, Anisa Shaker. Retrospective study of patients with esophageal squamous cell carcinoma in an urban safety net county hospital [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D103.