Oesophageal cancer Flashcards
Adenocarcinoma
Most common type in UK/USA
Lower third- near the junction
Risk factors
- GORD
- Barret’s oesophagus
- smoking
- achalasia
- obesity
Squamous cell cancer
Most common in developing world
Upper two thirds of oesophagus
Risk factors
- smoking
- alcohol
- achalasia
- Plummer Vinson syndrome
- diets rich in nitrosamines
Features
Dysphagia is most common presenting symptom
Anorexia and weight loss
Vomiting
Hoaresness, melaena, cough
Diagnosis
Upper GI endoscopy with biopsy
Endoscopic US preferred method for locoregional staging
CT CAP for initial staging
Treatment
Operable disease best managed by surgical resection (Ivor-Lewis type oesophagectomy)
Biggest surgical challenge is anastomotic leak with intrathoracic anastomosis resulting in mediastinitis
Adjuvant chemotherapy