[The natural history and complications of esophageal cancer]

Squamous cell carcinoma of the oesophagus has a poor prognosis, owing in part to the compromised status of the patients. Early oesophageal cancer is rarely diagnosed, even if its endoscopic aspects are well known. From the mucosa, the disease progresses step by step, and also via the submucosa. Furthermore, multiple locations are not uncommon. Bulky tumours progressively obstruct the oesophageal lumen while infiltrative tumours invade the oesophageal layers, and then the perioesophageal fat and the mediastinal organs. Involvement of mediastinal, cervical and abdominal lymph nodes occurs early. Distant metastases occur later. Complications are mainly due to the locoregional spread of the disease, leading to death.