GI - Oesophageal Cancer Flashcards

1
Q

Epidemiology of oesophageal cancer

A
  • Middle aged men (50-70 ya)
  • Male> female
  • higher incidence with Barrett’s oesophagus
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2
Q

Risk factors for oesophageal cancer

A
  • Alcohol
  • Smoking
  • Achalasia
  • GORD (Barrett’s)
  • Plummer-Vinson
  • Fatty diet
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3
Q

What is the pathophysiology of oesophageal cancer?

A
  • 65% adenocarcinomas (GORD, obesity, fatty diet): lower 1/3
  • 35% SCC: upper and middle 1/3, associated with ethanol and smoking
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4
Q

Oesophageal cancer: presentation

A
  • Progressive dysphagia of solids, progressive to Lisa users
  • Often altered dietary habits with soft foods and wt loss
  • Retrosternal chest pain
  • lymphadenopathy
  • Upper 1/3: hoarseness: recurrent laryngeal N invasion + cough +/- aspiration pneumonia
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5
Q

Oesophageal cancer: Ix - bloods

A
  • FBC: Anaemia

- LFTs: hepatic mets, low albumin

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6
Q

Oesophageal cancer: Dx methods

A
  • Upper GI endoscopy with biopsy
  • Ba swallow: not often used but could show apple core stricture
  • Staging (TNM): CT
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7
Q

Outline the TNM structure for oesophageal cancer

A
  • Tis: carcinoma in situ
  • T1: submucosa
  • T2: muscularis propria (circ/long)
  • T3: adventicia
  • T4: adjacent structures
  • N1: regional nodes
  • M1: distant mets
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8
Q

Treatment: surgical and palliative

A
  • Surgical: only 25-30% have resectable tumours - may have some new-adjuvant chemo before surgery. Prognosis is stage dependent but 15% 5year survival
  • Palliative: majority of pts - stenting, laser coagulation, analgesia, radiotherapy + referral to Macmillan/palliative care team.
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9
Q

What are some benign tumours of oesophagus

A
  • Leiomyoma
  • Lipomas
  • Haemangiomas
  • Benign polyps
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