1. The evolution of esophageal cancer between 2008-2013 in Mureș county Coordinator: Dr. Radu Florin Demian First author: Pál Hunor

2. Background – Worldwide and EU Worldwide (8th most common cancer) - 2008 - 481,645 cases - 2012 - 456,000 cases Rate of incidence - highest in South Africa ( ♂, ♀ ) -lowest in West of Africa ( ♂ ) and South Europe ( ♀ ). -83% in less developed regions of the world - 5 th most common cancer in men In the EU, 2008: - highest rates: UK, 14 ( ♂ ) and 5 ( ♀ )cases/100,000 pers. - lowest rates: Cyprus ( ♂ ) and Greece ( ♀ ) (1 case and less than 1 case/100,000 pers.)

3. Background – Romania (rate per 100,000 pers.) 1996 - incidence 3 -mortality 1,7 2000 - incidence 2,32 -mortality 2,04 2008 - incidence 3,9 -mortality 3,5 Mureș county (550.846 citizens) - lowest incidence in 2012, 0,3113% - highest incidence in 2013, 0,8751%

4. About Two major types - squamous cell carcinoma (SCC) - adenocarcinoma (AC) - < 1-2 % Sarcomas, small cell carcinomas and other types of cancer A. SCC - middle or upper 1/3 B. AC in the lower 1/3 or junction of the esophagus and stomach One of the least studied and deadliest cancers worldwide Extremely aggressive nature, poor survival rate.

5. Major aethiological factors Smoking Alcool consumption Malnutrition ( beta-carotene, B-vitamins, vitamin C and E, selenium) Barrett’s oesophagus

6. Aim, material and methods Follow the evolution of esophageal cancer in Mureș county between 2008-2013, by incidence, distribution by sexes, place of provenance, by group of ages, survivals and cytostatic threatment schemes. Retrospective study on 66 pacients (55 male, 11 female) - threated in the Oncology Clinics of Targu Mureș.

7. Distribution by sexes Distribution by sexes

8. Distribution by place of provenance

9. Distribution by group of ages

10. Survival curves

11. Cytostatic threatment 2012-2013  53 cycles, 11 schemes Cisplatin8 Carboplatin6 Gemcitabin7 Oxaliplatin2 5-FU3 Carboplatin + Docetaxel11 Carboplatin+ Paclitaxel7 Gemcitabin + Carboplatin4 Capecitabin + Cisplatin2 Epirubicin + Cisplatin2 Epirubicin ă + Oxaliplatin ă 1

12. Conclusions Low incidence More frequent at males More frequent at rural areas Most of cases are between 51-60 ages (31/66), no cases below 40 Simultaneous decrease of the age group 61-70 and increase of 41-50 Two year survival is low Managing major risk factors (especially smoking and alcool consumption) should reduce the incidence, or at least prevent appearing at younger ages (41-50).

13. Thanks for the attention!