• Shaul Pery, Fadi Abu Baker, and Yael Kopelman.
• Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera, Israel, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
• Isr Med Assoc J. 2023 May 1; 25 (5): 328331328-331.

BackgroundEsophageal cancer is comprised of adenocarcinoma and squamous cell carcinoma and is the sixth leading cause of cancer-related mortality worldwide. Upper endoscopy may reveal a partially or completely lumen-occluding mass at diagnosis, yet the prognostic significance of such a presentation is not clear.ObjectivesTo investigate whether endoscopic obstructing lesions have a meaning regarding patient prognosis.MethodsWe reviewed upper gastrointestinal endoscopic studies performed over a 20-year period (2000-2020). We compared overall survival, disease stage, histologic criteria, and anatomic location of the lesions in esophagus lumen-obstructing and non-obstructing tumors. Differences between the two groups were statistically evaluated.ResultsSixty-nine patients were diagnosed with histologically confirmed esophageal cancer. As assessed through endoscopy, 32/69 (46%) patients had obstructive and 37/69 (54%) had non-obstructive cancers. Median survival was significantly shorter in the lumen-obstructing lesions compared with the non-obstructing lesions (3.5 months vs. 10 months, P = 0.001). Female median survival displayed a trend toward shorter survival compared to males (3.5 months vs. 10 months, P = 0.059). There was no statistically significant difference in the percentages of advanced, stage IV disease in the obstructive group and the non-obstructive group (11/32 [34.3%] and 14/37 [37.8%], respectively P = 0.80).ConclusionsObstructive esophageal cancers predict shorter median overall survival compared with non-obstructive cancers, without any correlation between obstruction of the lesion and tumor metastatic stage.

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