Oesophageal carcinoma associated with corrosive injury - Prevention and treatment by oesophageal resection

Abstract

Six patients (5 from Kuala Lumpur and 1 from Singapore), who had a history of corrosive injury in late adolescence and early adult life, developed oesophageal squamous cell carcinoma. The association between corrosion and carcinoma was probably causal in 5 women who developed oesophageal cancer 25-50 years after corrosive injury and coincidental in a 35-year-old man with a recent history of corrosive ingestion. The 5 patients from Kuala Lumpur were among a series of 49 patients treated over a 10-year period for dysphagia from corrosive injury. Excluding the patient with coincidental association, the 4 patients with corrosive-induced carcinoma represent an 8 per cent incidence of malignancy in the series of 49 patients. Reference is made to the safety of oesophageal resection in 28 patients with associated carcinoma. Oesophageal resection during reconstructive surgery for severe corrosive stricture would have a preventive role in corrosive induced carcinoma. However, these cases suggest that patients with relatively mild corrosive injury not requiring reconstructive surgery are also at risk of oesophageal carcinoma. An awareness of this risk should lead to earlier diagnosis of carcinoma and an increase in the number of curative resections.