Oesophageal Cancer

Question 1

what is the incidence of oesophageal cancer in the UK?

Answer 1

9 per 100,000

Question 2

What are the risk factors of oesophageal cancer?

Answer 2

1) diet
2) alcohol excess
3) smoking
4) achalasia
5) Plummer-vinson syndrome
6) obesity
7) low vitamin A and C intake
8) GORD associated oesophagitis / barrett’s oesophagus

Question 3

What is the male to female ratio of oesophageal cancer

Answer 3

male : female 5:1

Question 4

What percentage of oesophageal cancers occur in the upper part ?

Answer 4

20%

Question 5

What percentage of oesophageal cancers occur in the middle and lower?

Answer 5

50% - middle

30% - lower

Question 6

Where do squamous cell oesoph cancers occur?

Answer 6

proximal part

Question 7

Where do adenocarcinomas of the oesoph occur?

Answer 7

distal

Question 8

How does oesophageal cancers present?

Answer 8

• dysphagia
• weight loss
• retrosternal pain

Question 9

What are the signs of an upper oesophageal cancer?

Answer 9

• hoarse voice
• cough
• dysphagia

Question 10

What tests are done for an oesophageal cancer?

Answer 10

• endoscopy with biopsy
• endoscopy USS
• CT/MRI for staging

Question 11

What are the treatments for oesophageal cancer?

Answer 11

• if localised T1 or T2 then radical curative oesophagectomy.
• PreOp chemo - cisplati
• chemoradiotherapy if surgery not indicated
• Palliative chemoradiotherapy and stenting to improve symptoms.

Question 12

What does a TNM staging of T4, N1, MI indicate?

Answer 12

T4 - invasion of adjacent structures
N1 - regional node mets
M1 - distant mets

Question 13

What does a TNM staging of T2, N0 , M0 indicate?

Answer 13

T2 - invading muscularid propria
N0 - no node spread
M0 - no distant mets

Question 14

What does Tis, T1, T2, T3 and T4 indicate in TNM staging?

Answer 14

Tis - carcinoma in situ
T1 - invading lamina propria / submucosa
T2 - invading muscularis propria
T3 - Invading adventitia
T4 - invasion of adjacent structures