Esophageal cancer overview: Difference between revisions
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==Overview== | ==Overview== | ||
'''Esophageal cancer''' is [[cancer|malignancy]] of the [[esophagus]]. There are various subtypes. Esophageal tumors usually lead to [[dysphagia]], [[odynophagia]], [[weight loss]], and [[hematemesis]] and are diagnosed with [[biopsy]]. Esophageal cancer must be differentiated from [[gastroesophageal reflux disease]] (GERD), [[ | '''Esophageal cancer''' is [[cancer|malignancy]] of the [[esophagus]]. There are various subtypes. Esophageal tumors usually lead to [[dysphagia]], [[odynophagia]], [[weight loss]], and [[hematemesis]] and are diagnosed with [[biopsy]]. Esophageal cancer must be differentiated from [[gastroesophageal reflux disease]] (GERD), [[barrett's esophagus]], [[esophageal achalasia]], [[gastritis]], [[gastric ulcer]], and [[stomach cancer]]. Common risk factors in the development of esophageal cancer are [[tobacco smoking]], [[alcohol]], [[gastroesophageal reflux disease]], and [[barrett's esophagus]]. Small and localized tumors are treated with [[surgery]], and advanced tumors are treated with [[chemotherapy]], [[radiation therapy|radiotherapy]] or combinations. Prognosis depends on the extent of the disease and other medical problems, but is fairly poor.<ref name=Enzinger>Enzinger PC, Mayer RJ. Esophageal cancer. ''[[N Engl J Med]]'' 2003;349:2241-52. PMID 14657432.</ref> | ||
==Classification== | ==Classification== | ||
Esophageal cancer may be classified into [[squamous cell carcinoma]] or [[adenocarcinoma]] based on [[histology]]. | Esophageal cancer may be classified into [[squamous cell carcinoma]] or [[adenocarcinoma]] based on [[histology]]. | ||
Revision as of 13:55, 6 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
Esophageal cancer is malignancy of the esophagus. There are various subtypes. Esophageal tumors usually lead to dysphagia, odynophagia, weight loss, and hematemesis and are diagnosed with biopsy. Esophageal cancer must be differentiated from gastroesophageal reflux disease (GERD), barrett's esophagus, esophageal achalasia, gastritis, gastric ulcer, and stomach cancer. Common risk factors in the development of esophageal cancer are tobacco smoking, alcohol, gastroesophageal reflux disease, and barrett's esophagus. Small and localized tumors are treated with surgery, and advanced tumors are treated with chemotherapy, radiotherapy or combinations. Prognosis depends on the extent of the disease and other medical problems, but is fairly poor.[1]
Classification
Esophageal cancer may be classified into squamous cell carcinoma or adenocarcinoma based on histology.
Pathology
The pathophysiology of esophageal cancer depends on the histological subtype.
Differential diagnosis
Esophageal cancer must be differentiated from gastroesophageal reflux disease (GERD), Barrett's esophagus, esophageal achalasia, gastritis, gastric ulcer, and stomach cancer.
Epidemiology and Demographics
The majority of esophageal cancer cases are reported in the “Asian belt” area which includes China, Japan, India, Iran, Turkey, among other Middle Eastern countries.
Risk Factors
Common risk factors in the development of esophageal cancer are tobacco smoking, alcohol, gastroesophageal reflux disease, and Barrett's esophagus.
Prognosis
Esophageal cancer is associated with a 5 year survival rate of 20%.
Staging
According to the American Joint Committee on Cancer, there are 4 stages of esophageal cancer based on the tumor spread.
History and Symptoms
Symptoms of esophageal cancer include dysphagia, odynophagia, weight loss, and hematemesis.
Physical examination
Physical examination of patients with esophageal cancer is usually unremarkable.
Laboratory Findings
There are no diagnostic lab findings associated with esophageal cancer.
CT
CT scan may be diagnostic of esophageal cancer. Findings on CT scan suggestive of esophageal cancer include either eccentric or circumferential wall thickening or peri-esophageal soft tissue and fat stranding.
MRI
There are no MRI scan findings associated with esophageal cancer.
Other Imaging Findings
Other imaging studies for esophageal cancer include barium swallow. Findings on barium swallow suggestive of esophageal cancer include irregular strictures, pre-stricture dilatation with 'hold up', and shouldering of the strictures.
Other Diagnostic Studies
Other diagnostic studies for esophageal cancer include FDG-PET (positron emission tomography) scan and endoscopic ultrasound (EUS).
Medical Therapy
The predominant therapy for esophageal cancer is surgical resection. Adjunctive chemotherapy and radiation may be required. Drugs approved for the treatment of esophageal cancer include Ramucirumab, Docetaxel, Trastuzumab, and Ramucirumab.
Surgery
The predominant therapy for esophageal cancer is surgical resection. Adjunctive chemotherapy and radiation may be required.
Primary Prevention
Effective measures for the primary prevention of esophageal cancer include the treatment of gastroesophageal reflux disease and Barrett's esophagus, weight loss, avoidance of tobacco and alcohol, and a diet rich in fruits and vegetables.
References
- ↑ Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med 2003;349:2241-52. PMID 14657432.