Oesophageal Cancer Flashcards
What is oesophageal cancer?
It is defined as the proliferation of malignant cells in the oesophagus
How common is oesophageal cancer?
It is the third most common malignancy of the gastrointestinal tract
What are the two classifications of oesophageal cancer?
Adenocarcinoma
Squamous Cell Carcinoma
What is the most common classification of oesophageal cancer in the UK?
Adenocarcinoma
What is oesophageal adenocarcinoma?
It is malignancy that affects the mucus glandular cells of the oesophagus
Which region of the oesophagus tends to be affected by adenocarcinoma?
The lower third of the oesophagus, near the gastroesophageal junction
What are the five risk factors associated with oesophageal adenocarcinoma?
Gastro-Oesophageal Reflux Disease
Barrett’s Oesophagus
Achalasia
Smoking
Obesity
What is the most common classification of oesophageal cancer in the developing world?
Squamous cell carcinoma
What is oesophageal squamous cell carcinoma?
It is malignancy that affects the squamous cells of the oesophagus
Which region of the oesophagus tends to be affected by squamous cell carcinoma?
The upper two thirds of the oesophagus
What are the five risk factors associated with oesophageal squamous cell carcinoma?
Plummer-Vinson Syndrome
Achalasia
Smoking
Alcoholism
Nitrosamine Diets
What is Plummer-Vinson syndrome (PVS)?
It is a condition defined by a triad of microcytic hyporchromic anaemia, atrophic glossitis and oesophageal strictures
What six clinical features are associated with oesophageal cancer?
Dysphagia
Odynophagia
Heartburn Features
Chronic Cough
Hoarseness
Weight Loss
What is the most common presenting clinical feature of oesophageal cancer?
Dysphagia
What is odynophagia?
It is defined as a painful sensation in the oesophagus that occurs in relation to swallowing
What three investigations are used to diagnose oesophageal cancer?
Endoscopy + Biopsy
CT Scan
Endoscopic Ultrasound
What is the gold standard investigation used to diagnose oesophageal cancer?
Endoscopy + biopsy
How is endoscopy, with biopsy, used to investigate oesophageal cancer?
The histological examination enables classification of oesophageal cancer; however, the location of the mass on endoscopy is also indicative
How are CT scans used to investigate oesophageal cancer?
They are used to initially stage oesophageal cancer
What is the second line investigation is used to stage oesophageal cancer, in cases where metastases are not visualised on initial CT scans?
FDG-PET CT scan
How is endoscopic ultrasound used to investigate oesophageal cancer?
It is is used to determine the locoregional stage of oesophageal cancer
What are the two surgical management options used in oesophageal cancer?
Ivor-Lewis Oesophagectomy
Trans-Hiatal Oesophagectomy
When is Ivor-Lewis oesophagectomy recommended to manage oesophageal cancer?
It is the first line surgical management option of oesophageal cancer involving the lower and middle third of the oesophagus
What is Ivor-Lewis oesophagectomy?
It involves removal of the tumour through an abdominal incision and right thoracotomy
When is trans-hiatal oesophagectomy recommended to manage oesophageal cancer?
It is the first line surgical management option of oesophageal cancer involving the upper third of the oesophagus
What is trans-hiatal oesophagectomy?
It involves removal of the tumour through an abdominal incision and a left gastric neck incision
How is gastrointestinal function restored following oesophagectomy?
There is anastomosis between the stomach and remaining oesophagus
What feeding option should be selected following oesophagectomy?
Feeding Jejunostomy
What is the most common complication associated with oesophagectomy?
Anastomosis leak
How is chemotherapy used to manage oesophageal cancer?
It can be administered neoadjuvantly or adjuvantly, in combination with surgical management techniques to improve the likelihood of success
