ESOPHAGEAL

CANCER
INCIDENCE

• 8TH
LEADING CAUSE OF CANCER
• 7TH
LEADING CAUSE OF CANCER DEATHS in men (2018)
• MORE COMMON IN AFRICAN AMERICANS
ETIOLOGY AND RISK FACTORS

• AGE
• MALE > FEMALE
• GERD
• SMOKING
• OBESITY
• ALCOHOL
• LOW FIBER DIET
• DRY CLEANING AGENTS AND LYE
RISK FACTORS

• BARRETT’S ESOPHAGUS
• ACHALASIA
• TYLOSIS
• ESOPHAGEAL WEBS
• PLUMMER VINSON SYNDROME

• GENETICS
BARRET’S ESOPHAGUS
TYLOSIS
ESOPHAGEAL WEB
PREVENTION

• AVOIDANCE OF RISK FACTORS

CLASSIFICATION

• ADENOCARCINOMA
• SQUAMOUS CELL CARCINOMA
• MUCOEPIDERMOID CARCINOMA
• SMALL CELL CARCINOMA
• SARCOMA
• MELANOMA
• ADENOID CYCTIC CARCINOMA
• LYMPHOMA
CLINICAL MANIFESTATIONS

• DYSPHAGIA
• GERD OR HEART BURN
• PAIN
DIAGNOSTIC TESTS

• ENDOSCOPY AND BIOPSY

• BARIUM SWALLOW
• ENDOSCOPIC ULTRASONOGRAPY
• CT SCAN
• PET
STAGING

• STAGE 0 – Tis, N0,M0

• STAGE 1 – T1,N0,M0
• STAGE II A – T2,N0M0 OR T3N0M0
• STAGE II B – T1N1M0 OR T2N1M0
• STAGE IIIA – T3,N1M0 OR T4, ANY N M0
• STAGE IV – Any T Any N M1
• STAGE IV A – ANY T, ANY N Mia ( METASTASIS IN CELIAC LYMPH NODES)
• STAGE IV B – ANY T ANY N M1b ( OTHER DISTANT METASTASIS )
MANAGEMENT

• EARLY STAGE – ESOPHAGECTOMY

• RADIATION THERAPY
• CHEMOTHERAPY
– CISPLATIN, MITOMYCIN, 5FU, PACLITXEL, VINDESINE
– CISPLATIN AND 5FU ARE MOST COMMON SINGLE AGENTS
COMPLICATIONS

• DISEASE RELATED
– WEIGHT LOSS/ ANOREXIA
– HEMATEMISIS/MELENA
– HEMOPTYSIS
– DYSPHONIA
– SVC SNDROME
– MALIGNANT PLEURAL EFFUSION
– MALIGNANT ASCITES
– BONE PAIN AND LARYNGEAL NERVE PALSY
COMPLICATIONS

• TREATMENT RELATED – CHEMOTHERAPY

– NAUSEA AND VOMITING
– NEPHROTOXICITY
– MYELOSUPPRESION
– MUCOSITIS/ DIARRHEA
– PERIPHERAL NEUROPATHY AND SKIN TOXICITY
• TREATMENT RELATED – RADIATION
– PNEUMONITIS
– STRICTURE
– FISTULA