Podcast
Questions and Answers
What is the most common symptom of esophageal carcinoma?
What is the most common symptom of esophageal carcinoma?
Which type of esophageal cancer is most frequently found in the upper parts of the esophagus?
Which type of esophageal cancer is most frequently found in the upper parts of the esophagus?
Which of the following is a risk factor specifically associated with adenocarcinoma of the esophagus?
Which of the following is a risk factor specifically associated with adenocarcinoma of the esophagus?
What percentage range represents the overall 5-year survival rate for esophageal cancer?
What percentage range represents the overall 5-year survival rate for esophageal cancer?
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Which diagnostic method is recognized as the preferred test for establishing a diagnosis of esophageal carcinoma?
Which diagnostic method is recognized as the preferred test for establishing a diagnosis of esophageal carcinoma?
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Which of the following risk factors is associated with squamous cell carcinoma of the esophagus?
Which of the following risk factors is associated with squamous cell carcinoma of the esophagus?
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What is commonly observed in barium esophagography in patients with esophageal carcinoma?
What is commonly observed in barium esophagography in patients with esophageal carcinoma?
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Which method is routinely used to assess the depth of tumor penetration in esophageal cancer?
Which method is routinely used to assess the depth of tumor penetration in esophageal cancer?
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Study Notes
Epidemiology
- Esophageal cancer incidence varies worldwide, with high prevalence in Asia and Africa
- Sixth or seventh most common cancer globally
- Squamous cell carcinoma (SCC) most common in upper and middle third of esophagus (40% and 15% respectively)
- Adenocarcinoma (AC) most common in lower third and cardia (45% of tumors)
- SCC incidence decreasing in Western countries, while AC is rising
- 5-year survival rate ranges from 15% to 25%, dependent on stage at diagnosis
Classification
- Two main histological types: squamous cell carcinoma and adenocarcinoma
- SCC predominantly affects the upper esophagus, while AC affects the distal esophagus
Risk Factors - Adenocarcinoma
- Gastroesophageal reflux disease (GERD)
- Barrett's esophagus
- Tobacco use
- Obesity
- Chest irradiation
- Diet low in vegetables and fruits
- Older age
- Male sex
- Medications relaxing the lower esophageal sphincter (LES)
Risk Factors - Squamous Cell Carcinoma
- Tobacco and alcohol use
- Caustic injury
- Achalasia
- Human papillomavirus (HPV) infection
- Nitrosamine exposure
- Past thoracic irradiation
- Palmoplantar keratoderma
- Nutritional deficiencies (Zinc, Selenium)
- Poor socioeconomic status
Clinical Manifestations
- Dysphagia (difficulty swallowing) for solid foods, most common symptom
- Weight loss
- Iron deficiency anemia (secondary to gastrointestinal bleeding)
- Chest pain
- Anorexia (loss of appetite)
- Upper gastrointestinal bleeding
- Lung complications: aspiration pneumonia, cough, hoarseness
Paraclinical Investigations
- Barium esophagography
- Upper endoscopy with biopsy
- Endoscopic ultrasonography
- CT chest
- PET-CT widely used for preoperative staging
- HER2 gene mutation testing
Barium Radiography
- Shows esophageal lumen stenosis with irregular contour
- Overlying dilation of the esophagus
- Helps differentiate from achalasia
Achalasia
- Achalasia is a condition where the LES fails to relax properly, making it difficult for food to pass into the stomach.
Upper Endoscopy with Biopsy
- Preferred diagnostic test
- Establishes diagnosis
- Reveals tumor formation, including vegetative, ulcerative-vegetative, and infiltrative-stenotic forms
Endoscopic Ultrasonography
- Used to assess tumor penetration depth and involved lymph nodes
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Description
This quiz explores the epidemiology, classification, and risk factors associated with esophageal cancer, particularly focusing on squamous cell carcinoma and adenocarcinoma. Learn about the global incidence rates, survival rates, and the impact of lifestyle choices on cancer risk. Test your knowledge on this critical topic in oncology.
