CHALLENGES IN THE ESOPHAGEAL CANCER STAGING IN BRAZIL

Esophageal cancer has a high incidence in several regions of the country. Nevertheless, we observe the difficulty in performing the necessary staging exams and the lack of clinical data, particularly in services from the Public Health System. This study aims to evaluate the absence of clinical information and staging exams in esophageal cancer. We conducted an observational, retrospective, and crosssectional, single-institute study. One hundred seventynine consecutive patients diagnosed with esophageal cancer, from 2015 to 2017, from Public Health System were analyzed. Information on demographics, clinical data, predictive, and prognostic risk factors was retrieved. The classic risk factors, smoking and alcoholism, were not described in 22% and 23% of the patients, respectively. The nutritional status was not reported in almost 17% of the patients. The need for alternative feeding method was not described in 83 patients. Squamous cell carcinoma (SCC) was present in 126 patients (81%) and adenocarcinoma in 15 patients (8%). The histologic classification was not reported in 13.4% of patients. One hundred eighteen patients (66%) presented no information on the tumor size. Tumor location was described in all patients. There were 132 patients (73%) without T staging, 102 (57%) without evaluation of lymph node involvement, and 106 (59%) without evaluation of distant metastases. In conclusion, we observe a significant lack of information for patients with esophageal cancer treated by the Public Health System. This lack may impact negatively in the correct evaluation and treatment of these patients, as in their prognostic.