Carcinoma of the esophagus

Carcinoma of the esophagus remains difficult to detect while it is localized to the mucosa. The ideal treatment is removal of all tissue that contains tumor. Usually reconstruction using the stomach is preferred over the use of gastric tubes, colon, and jejunum, although these will serve satisfactorily. Maximal palliation with relief of dysphagia is best achieved by removal of the obstructing lesion when possible, even if some tumor remains. When resection is not practical, bypass anastomoses proximal to the tumor occasionally may be used to relieve the obstruction and the associated dysphagia. Irradiation and chemotherapy may improve the results of therapy. To permit earlier detection, better screening tests are needed.