Esophageal cancer Flashcards
What are the 2 major subtypes of oesophageal cancer?
Squamous cell carcinoma (most common)
Adenocarcinoma
Name risk factors for oesophageal SCC
Smoking Alcohol Diet Recurrent thermal injury Nitrosamines Caustic injury HPV RT Esophageal candidiasis Tylosis Plummer-Vinson syndrome Diverticula Achalasia
Name risk factors for oesophageal adenocarcinoma
Smoking Obesity Male Older GERD Barret's
What is the localization of oesophageal adenocarcinoma?
Lower 1/3
What is the localization of oesophageal SCC?
Upper 2/3
Name typical symptoms of oesophageal cancer
Progressive dysphagia (solids to fluids) Weight loss Anorexia Fatigue Vomit blood Malena stools
Name symptoms of local invasion of oesophageal cancer
Coughing, choking, recurrent pneumonia (TOF)
Hoarseness
How is dysphagia graded?
Mellow and Pinkas
Give the Mellow and Pinkas dysphagia grading scale
0 - able to eat normally 1 - able to swallow some solids 2 - able to swallow only semi-solids 3 - able to swallow only liquids 4 - unable to swallow anything
Name signs of metastases in oesophageal cancer
Constitutional symptoms Jaundice Hepatomegaly Virchow's node Pleural effusions
Name the most common sites of oesophageal cancer metastasis
LN Lung Liver Bones Brain Adrenal glands Peritoneum
Name investigations in oesophageal cancer
Barium swallow
Endoscopy and biopsy
General: Bloods CXR ECG Echo Lung function test
Staging: CT Endoscopic U/S PET Staging laparoscopy
Name features of oesphageal cancer on Barium swallow
Apple core stricture Shouldering Proximal dilation Axis deviation/angulation TOF
What tumour characteristics should be documented at endoscopy?
Site Length of lesion Circumferential involvement Obstruction Adjacent lesions
How is oesophageal cancer staging classified?
AJCC TNM classification
