Esophageal Cancer Questions & Answers

Updated: Feb 27, 2019
  • Author: Muhammad Masab, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Questions & Answers

Overview

What is esophageal cancer?

What are the signs and symptoms of esophageal cancer?

Which physical findings suggest esophageal cancer?

What is the role of lab tests in the evaluation of esophageal cancer?

What is the role of imaging studies in the evaluation of esophageal cancer?

What are the treatment options for esophageal cancer?

When is surgery indicated for esophageal cancer?

What are the contraindications for surgery for esophageal cancer?

What are surgical options for the treatment of esophageal cancer?

What are palliative care options for esophageal cancer?

What are patient education resources for esophageal cancer?

How common is esophageal cancer?

What are the principal histologic types of esophageal cancer?

Who is at highest risk for adenocarcinoma esophageal cancer?

Where in the esophagogastric junction do squamous cell carcinoma (SCC) and adenocarcinoma typically occur?

What is preferred treatment for esophageal cancer?

What is the anatomy of the esophagus?

From which artery is the blood supply for the esophagus derived?

How does venous drainage of the esophagus occur?

What are the lymphatic channels in the esophagus that facilitate esophageal cancer?

What are the major risk factors for SCC esophageal cancer?

What is the role of alcohol in the pathophysiology of esophageal cancer?

Which tobacco carcinogens have a role in the pathogenesis of esophageal cancer?

What is the role of carcinogens in the pathogenesis of SCC esophageal cancer?

What is the pathophysiology of adenocarcinoma esophageal cancer?

What is the role of Barrett metaplasia in esophageal adenocarcinoma?

What is the role of obesity in the pathogenesis of esophageal adenocarcinoma?

What is the role of tylosis in the pathogenesis of SCC esophageal cancer?

What is the etiology of esophageal cancer?

What are the risk factors for esophageal cancer?

What are the risk factors for SCC esophageal cancer?

How much does smoking and alcohol consumption increase the risk of SCC esophageal cancer?

Which dietary factors increase or decrease the risk of SCC esophageal cancer?

Which genetic factors may increase the risk of SCC esophageal cancer?

Which infections may be etiological factors in esophageal cancer?

What are the principal etiologic factors for esophageal adenocarcinoma?

What is the most common predisposing factor for esophageal adenocarcinoma?

What is the risk of esophageal adenocarcinoma in patients with Barrett metaplasia?

What is the risk of developing esophageal adenocarcinoma in patients with gastroesophageal reflux disease (GERD)?

What are risk factors for esophageal adenocarcinoma?

How does obesity affect the risk for esophageal adenocarcinoma?

What is the incidence of esophageal cancer in the US?

What is the global incidence of esophageal cancer?

How does the incidence of esophageal cancer vary by sex?

How does the incidence of esophageal cancer vary by age?

What is the survival rate for esophageal cancer?

Which PET scan finding suggests poorer overall survival in patients with esophageal cancer?

What can be used to predict survival in esophageal cancer?

Which genetic mutation is a negative prognostic indicator in esophageal cancer?

Presentation

What is the most common presenting symptom of esophageal cancer?

What are the signs and symptoms of esophageal cancer?

Which physical findings suggest patients with esophageal cancer?

DDX

Which esophageal lesions should be included in the differential diagnosis of esophageal cancer?

How is achalasia differentiated from esophageal cancer?

How is esophageal stricture differentiated from esophageal cancer?

What are the differential diagnoses for Esophageal Cancer?

Workup

What are the Society of Thoracic Surgeons recommendations for the diagnosis of esophageal cancer?

Which imaging studies are performed in the diagnosis and staging of esophageal cancer?

What is the role of a barium swallow in the diagnosis and staging of esophageal cancer?

What is the role of CT scanning in the diagnosis of esophageal cancer?

What is the role of PET scanning in the evaluation of esophageal cancer?

What is the role of EUS in the evaluation of esophageal cancer?

Which EUS findings are characteristic of esophageal cancer?

What is the accuracy of EUS for the diagnosis of esophageal cancer?

What are the risks of EUS for staging esophageal cancer?

What is the role of bronchoscopy in the evaluation of esophageal cancer?

What classification systems are used outside the US for staging esophageal cancer?

Which staging system is used for esophageal cancer?

How is esophageal cancer staging evolved?

What is the 2017 AJCC/UICC TNM classification for esophageal cancer?

What are the limitations of the AJCC/UICC TNM staging system for esophageal cancer?

What is the role of lab testing in the evaluation of esophageal cancer?

What is the role of upper GI endoscopy in the evaluation and management of esophageal cancer?

What do diagnostic endoscopies for esophageal cancer determine?

How does tumor length predict long-term survival in esophageal adenocarcinoma?

What is the role of endoscopic resection (ER) of focal nodules is the staging of esophageal cancer?

Which histologic findings are characteristic of esophageal cancer?

Treatment

Which factors impact the choice of treatment for esophageal cancer?

What are the NCCN treatment recommendations for esophageal cancer?

What are the indications for surgery for esophageal cancer?

What are the contraindications for surgery of esophageal cancer?

Which comorbidities decrease survival rates from esophageal resection of esophageal cancer?

When is esophageal resection (esophagectomy) indicated in the treatment of esophageal cancer?

How is esophageal resection (esophagectomy) performed in the treatment of esophageal cancer?

What are complications of esophageal resection (esophagectomy) in esophageal cancer?

What is the treatment for anastomotic leaks from esophageal resection (esophagectomy)?

How do leak rates vary by location in an esophageal resection (esophagectomy) for esophageal cancer?

What has been shown to decrease the mortality rate of esophageal resection (esophagectomy) for esophageal cancer?

What are the benefits of a team approach to surgery of esophageal cancer?

What are the types of transthoracic esophagectomy (TTE) used for the treatment of esophageal cancer?

How is a transthoracic esophagectomy (TTE) performed in esophageal cancer?

How is a transhiatal esophagectomy (THE) performed in esophageal cancer?

What are the advantages of minimally invasive surgery for the treatment of esophageal cancer?

What is the role of video-assisted thoracoscopy (VATS) in the treatment of esophageal cancer?

What is the role of sentinel node mapping for the treatment of esophageal cancer?

What is the role of endoscopic mucosal resection (EMR) in the treatment of esophageal cancer?

What is the indication for a salvage endoscopic therapy (SET) in esophageal cancer and what is its efficacy?

What is the role of CRT in the treatment of esophageal cancer?

What is the role of neoadjuvant chemotherapy for esophageal cancer?

What is the benefit of preoperative CRT for the treatment of esophageal cancer?

What is neoadjuvant therapy for esophageal cancer and what is its efficacy?

What is the response rate to preoperative CRT for esophageal cancer and how affect survival rates?

What is the role of biomarkers in the treatment of esophageal cancer?

What is the role of enteral nutrition in the treatment of esophageal cancer?

What is the efficacy of laser therapy for palliative treatment of esophageal cancer?

What is the goal of palliative care for esophageal cancer?

How does dysphagia affect palliative care selection for esophageal cancer?

What palliative care options for the management of dysphagia in esophageal cancer?

What are the NCCN recommendations for palliative care of complete esophageal obstruction in esophageal cancer?

What is the role of stents in the palliation of dysphagia in esophageal cancer?

What is the efficacy of radiotherapy for palliative treatment of esophageal cancer?

What is the efficacy of chemotherapy for palliative treatment of esophageal cancer?

What is the typical length of hospitalization for esophageal cancer treatment?

When are patients extubated after surgery to treat esophageal cancer?

When does postoperative feeding through the jejunostomy begin in esophageal cancer?

How frequently do patients return home after surgery for esophageal cancer?

What postoperative follow-up for esophageal cancer is required?

How can esophageal cancer be prevented?

What is the indication for surveillance upper endoscopy with biopsy for esophageal cancer?

Guidelines

What are the ACP recommendations for upper endoscopy for gastroesophageal reflux disease (GERD)?

Which organizations have released screening guidelines for GERD) and/or Barrett esophagus?

What are the recommendation for screening for Barrett esophagus or esophageal adenocarcinoma?

What are the ASGE guidelines for the use of endoscopy in the management of gastroesophageal reflux disease (GERD)?

What are the ACG guidelines for the surveillance and therapy of Barrett esophagus?

What is the indication for radiofrequency ablation (RFA) for the treatment of Barrett esophagus with dysplasia?

What is PDT for the treatment of Barrett esophagus?

How do surveillance strategies for esophageal cancer vary by disease stage?

What are the STS recommendations for diagnosis and treatment of localized esophageal cancer?

What are the ASGE recommendations for the use of endoscopy in the assessment and treatment of esophageal cancer?

What are the CAP-ASCP-ASCO recommendations for HER2 testing in esophageal cancer?

What are the NCCN guidelines for HER-2 testing in the evaluation for esophageal cancer?

What are the ACG recommendations for endoscopic treatment of Barrett esophagus in esophageal cancer?

What are the NCCN treatment recommendations for esophageal cancer?

What are the NCCN guidelines for surgical therapy of esophageal cancer?

What are the STS recommendations for multimodal treatment of esophageal cancer?

What are the NCCN treatment guidelines for metastatic or recurrent esophageal cancer?

What are the NCCN guidelines for palliative care for esophageal cancer?

What are the ASGE recommendations for palliative care for esophageal cancer?

Medications

Which chemotherapy regimens have been approved by the FDA for the treatment of esophageal cancer?

Which preoperative chemoradiation regimens are used in the treatment of esophageal cancer?

What are the definitive chemoradiation regimens used in esophageal cancer?

When is perioperative chemotherapy used for the treatment of esophageal cancer?

When is preoperative chemotherapy used for the treatment of esophageal cancer?

Which regimen is used for preoperative and postoperative chemotherapy for esophageal cancer?

Which medications in the drug class Thymidine Analog are used in the treatment of Esophageal Cancer?

Which medications in the drug class Antineoplastics, Topoisomerase Inhibitors are used in the treatment of Esophageal Cancer?

Which medications in the drug class Antineoplastics, Anthracycline are used in the treatment of Esophageal Cancer?

Which medications in the drug class Antineoplastics, Antimicrotubular are used in the treatment of Esophageal Cancer?

Which medications in the drug class Antineoplastics, Alkylating are used in the treatment of Esophageal Cancer?

Which medications in the drug class Antineoplastics, Antimetabolite are used in the treatment of Esophageal Cancer?