Oesophageal cancer Flashcards

1
Q

What is oesophageal cancer?

A

Most oesophageal cancers are mucosal lesions but originate in the epithelial cells lining the oesophagus.

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2
Q

What are the two main histological types of oesophageal cancer?

A

Squamous cell carcinoma

Adenocarcinoma

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3
Q

Aetiology of oesophageal cancer

A

Important factors implicated in the development of oesophageal adenocarcinoma include:
- GORD and Barrett’s oesophagus
-High BMI
-Male sex
- Diets high in total fat and saturated fat
Important factors implicated in the development of oesophageal squamous cell carcinoma include:
- Tobacco smoking
- Alcohol consumption
-HPV

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4
Q

Pathophysiology of oesophageal cancer

A
  • It arises in the mucosa and it progresses locally to invade the submucosa and muscular layer.
  • It may invade contiguous structures such as the tracheobronchial tree, aorta, recurrent laryngeal nerve
  • Metastasis typically occurs to the peri-oesophageal lymph nodes, liver and lungs.
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5
Q

Signs and symptoms of oesophageal cancer

A
Dysphagia (odynophagia) 
Weight loss 
Hoarseness 
Hiccups (uncommon) 
Post-prandial/ paroxysmal cough (uncommon)
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6
Q

Risk factors of oesophageal cancer

A
Male sex
Tobacco use 
Alcohol use 
GORD and Barrett's oesophagus 
Hiatus hernia
FHx of the oesophageal, stomach, oral or pharyngeal cancer
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7
Q

Investigations for the diagnosis of oesophageal cancer

A

OGD with biopsy

Comprehensive metabolic profile ( advanced cases- hypokalaemia)

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8
Q

Differentials of oesophageal cancer

A

Benign stricture
Achalasia
Barrett’s oesophagus

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9
Q

Management of oesophageal cancer

A
TNM staging important using CT 
Stage 0 and 1a: 
Endoscopic resection with or without ablation 
Stage 1, 2and 3:
Oesophagectomy (1st line)
Chemo/radiotherapy (2nd line)
Stage 4: Chemotherapy
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