Esophageal cancer overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Esophageal cancer is malignancy of the esophagus. There are various subtypes. Esophageal tumors usually lead to dysphagia (difficulty swallowing), pain and other symptoms, and are diagnosed with biopsy. 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 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 stricture, pre-stricture dilatation with 'hold up', and shouldering of the stricture.
Other Diagnostic Studies
Other diagnostic studies for esophageal cancer include FDG-PET (positron emission tomography) scan and endoscopic ultrasound (EUS).
References
- ↑ Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med 2003;349:2241-52. PMID 14657432.