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[Esophageal cancer]

R Cortés González1, R Villaseñor Caloca

  • 1Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, DF.

Revista De Gastroenterologia De Mexico
|July 1, 1997
PubMed
Summary

Esophageal cancer incidence varies globally, with higher rates in Central Asia. Diagnosis is often delayed, with surgery typically palliative, and survival rates remain low despite various treatment approaches.

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Area of Science:

  • Gastroenterology
  • Oncology
  • Epidemiology

Background:

  • Esophageal cancer exhibits significant geographical variation, with higher incidence in Central Asia compared to Western countries.
  • Tobacco and alcohol use are primary risk factors, and while squamous cell carcinoma is common, adenocarcinoma is increasing, possibly due to GERD and Barrett's esophagus.
  • Diagnosis is frequently delayed, with dysphagia and weight loss as common symptoms.

Purpose of the Study:

  • To review the epidemiology, diagnosis, staging, and treatment of esophageal cancer.
  • To highlight challenges in early detection and the impact of various therapeutic modalities on survival rates.

Main Methods:

  • Review of existing literature on esophageal cancer epidemiology, risk factors, and clinical presentation.
  • Analysis of diagnostic modalities including esophagography, endoscopy, CT, and endoluminal ultrasound for staging.
  • Evaluation of surgical techniques and the role of multimodal therapy in treatment.

Main Results:

  • Diagnostic accuracy for combined esophagography and endoscopy exceeds 95%.
  • CT and endoluminal ultrasound are crucial for staging, with endoluminal ultrasound potentially superior but less accessible.
  • Current surgical resections offer a 5-year survival rate of approximately 20%, with prognosis dependent on tumor biology and stage.

Conclusions:

  • Multimodality treatment, including neoadjuvant or adjuvant chemotherapy and radiotherapy, holds promise for improving survival rates.
  • Further investigation through controlled trials is needed to optimize treatment strategies for esophageal cancer.

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