- serosa
The esophagus has no , making it easy for tumors to
- invade outwards
- between 5 and 1 cm proximal to squamocolumnar junction or Z-line
Siewert classification of a type 1 tumor
- esophageal
- between 1 proximal and 2 cm distal to Z-line
Siewert classification of a type 2 tumor
- esophageal
- between 2 and 5 cm distal to anatomical Z-line
Siewert classification of type 3 tumor
- gastric
How far above and below do we treat for esophageal cancer? - 3 to 5 cm above and below
- Low incidence
- high mortality
Epidemiology of esophageal cancer
- most in Asia/Africa
- Esophageal cancer belt
- Northern Iran to central Asia
Esophageal cancer belt
- 90% squamous cell
- poor nutrition
Risk factors for esophageal cancer belt - low intake of fruits/veggies
- hot beverages
In the West, / account for 90% of esophageal squamous cell cancer - smoking / alcohol
- increases with age and peaks around 70-80
Epidemiology in the Us - adenocarcinoma now more prevalent than squamous (more distal lesions)
-
- "sticking" with progressive dysphagia to solids then liquids
- weight loss
- retrosternal discomfort/burning
Esophagus Presentation - hoarseness
- melena/hematemesis
- coughing/frequent pneumonia (TE fistula: abnormal connection between trachea and
esophagus)
- history/physical exam
Esophageal workup - EGD w/biopsy
- CT Chest, abdomen, pelvis
- adenocarcinoma
is 3-4x more common in men than woman
- squamous is equal
- Low SES
- smoking
- ETOH
- Areca nuts/betal quid chewing
- high temp beverage/food
Risk factors for esophageal cancer (squamous) - Red meat
- low fruit/veggie intake
- foods with N-nitroso compounds
- pre-existing achalasia/caustic strictures
- Tylosis
- bisphosphonates
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The esophagus has no , making it easy for tumors to
- invade outwards
- between 5 and 1 cm proximal to squamocolumnar junction or Z-line
Siewert classification of a type 1 tumor
- esophageal
- between 1 proximal and 2 cm distal to Z-line
Siewert classification of a type 2 tumor
- esophageal
- between 2 and 5 cm distal to anatomical Z-line
Siewert classification of type 3 tumor
- gastric
How far above and below do we treat for esophageal cancer? - 3 to 5 cm above and below
- Low incidence
- high mortality
Epidemiology of esophageal cancer
- most in Asia/Africa
- Esophageal cancer belt
- Northern Iran to central Asia
Esophageal cancer belt
- 90% squamous cell
- poor nutrition
Risk factors for esophageal cancer belt - low intake of fruits/veggies
- hot beverages
In the West, / account for 90% of esophageal squamous cell cancer - smoking / alcohol
- increases with age and peaks around 70-80
Epidemiology in the Us - adenocarcinoma now more prevalent than squamous (more distal lesions)
-
- "sticking" with progressive dysphagia to solids then liquids
- weight loss
- retrosternal discomfort/burning
Esophagus Presentation - hoarseness
- melena/hematemesis
- coughing/frequent pneumonia (TE fistula: abnormal connection between trachea and
esophagus)
- history/physical exam
Esophageal workup - EGD w/biopsy
- CT Chest, abdomen, pelvis
- adenocarcinoma
is 3-4x more common in men than woman
- squamous is equal
- Low SES
- smoking
- ETOH
- Areca nuts/betal quid chewing
- high temp beverage/food
Risk factors for esophageal cancer (squamous) - Red meat
- low fruit/veggie intake
- foods with N-nitroso compounds
- pre-existing achalasia/caustic strictures
- Tylosis
- bisphosphonates
1/3
