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Cancer > Oesophageal cancer > Flashcards

Oesophageal cancer Flashcards

1
Q

Epithelium histology of oesophagus?

A

Squamous

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2
Q

Epithelium histology of stomach?

A

Columnar

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3
Q

What is Barrett’s oesophagus?

A

Reflux causing metaplasia/dysplasia/adenocarcinoma

caused by obesity induced hiatus hernia

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4
Q

What is achalasia of the cardia?

A

Failure of the oesophageal sphincter to relax such that food can’t get into the stomach

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5
Q

Types of oesophageal cancer?

A

Adenocarcinoma - lower oesophagus, from reflux

Squamous carcinoma - upper oesophagus, Asia

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6
Q

Symptoms of oesophageal cancer?

A 
Dysphagia
Persistent indigestion/heartburn
Weight loss
Pain in throat/behind sternum
Persistent cough
Regurgitation of food
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7
Q

Investigations?

A

Oesophago-gastric-duodenoscopy (OGD)
FBC, U+Es, LFTs
CT CAP

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8
Q

Stage 0 =

A

High grade dysplasia

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9
Q

Stage 1a =

A

Submucosa

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10
Q

Stage 1b =

A

Muscles

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11
Q

Stage 2a =

A

Outside serosa

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12
Q

Stage 2b =

A

Involves muscles and 1-2 lymph nodes

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13
Q

Stage 3a =

A

Involves pleura, pericardium or diaphragm
or involves serosa and 1-2 nearby lymph nodes
or involves muscles and 3-6 nearby lymph nodes

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14
Q

T4, N0, M0 =

A

Stage 3a

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15
Q

T3, N1, M0 =

A

Stage 3a

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16
Q

T1/2, N2, M0 =

A

Stage 3a

17
Q

T3, N2, M0 =

A

Stage 3b

18
Q

Stage 3c =

A

Involves 6 LNs, pleura, heart or diaphragm
or involves trachea, vertebra/aorta and LNs
or involves >7 LNs

19
Q

T4a, N1/2, M0 =

A

Stage 3c

20
Q

T4b, N1-2, M0 =

A

Stage 3c

21
Q

T1-4, N3, M0 =

A

Stage 3c

22
Q

Stage 4 =

A

Distant metastases e.g. liver or lung

M1

23
Q

What surgical options are there?

A 
Endoscopic mucosal resection (EMR)
Endoscopic submucosal resection (ESD)
Ivor-Lewis oesophago-gastrectomy
Oesphagectomy
Stenting of the oesophagus as palliative
24
Q

2 drug chemo combo:

A

Cisplatin + fluorouracil (5FU)

Cisplatin + capecitabine (CX)

25
Q

3 drug chemo combo:

A

Epirubicin + cisplatin + capecitabine (ECX)

Epirubicin + oxaloplatin + capecitabine (EOX)

26
Q

Treatment for advanced cancer:

A

Herceptin in Her2 +ve

Epirabicin + cisplatin + fluorouracil (ECF)

27
Q

Diagnosis?

A

Endoscopy

CT CAP/endoscopic US for staging

28
Q

What is the Ivor-Lewis oesophagogastrectomy?

A

Removing lower third of oesophagus and upper stomach then mobilising the duodenum to join

Cancer (10 decks)

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