Esophageal cancer accounts for 5% of all GI cancers. There are 16,470 new cases and 14,280 deaths from esophageal cancer each year in the US. It is the sixth leading cause of death from cancer worldwide. Incidence increases with age, peaks at sixth to seventh decade. Male:female = 3.5:1. African-American males:White males = 5:1. Most common in China, Iran, South Africa, India, and the former Soviet Union. Risk factors: tobacco, EtOH, nitrosamines, Tylosis (congenitalhyperkeratosis), Plummer Vinson syndrome, achalasia, GERD, and Barrett’s esophagus. Four regions of the esophagus: Cervical = cricoid cartilage to thoracicinlet (15–18 cm from the incisor). Upper thoracic = thoracicinlet to tracheal bifurcation (18–24 cm). Midthoracic = tracheal bifurcation to just above the GE junction (24–32 cm). Lower thoracic = GE junction (32–40 cm).
KeywordsEsophageal Cancer Gastric Cardia Transhiatal Esophagectomy Cervical Anastomosis Tracheal Bifurcation
We thank Richard M. Krieg, for his valuable advice in the preparation of this chapter.
- Ajani JA, Winter K, Komaki R, et al. Phase II randomized trial of two nonoperative regimens of induction chemotherapy followed by chemoradiation in patients with localized carcinome of the esophagus: RTOG 0113. J Clin Oncol 2008;26:551-4556.Google Scholar
- al-Sarraf M, Martz K, Herskovic A, et al. Progress report of combined chemoradiotherapy versus radiotherapy alone in patients with esophageal cancer: an intergroup study. J Clin Oncol 1997;15:277-284.Google Scholar
- Allum WH, Fogarty PJ, Stenning SP, et al. Long term results of the MRC OEO2 randomized trial of surgery with or without preoperative chemotherapy in resectable esophageal cancer. Proc ASCO GI 2008, abstr 9.Google Scholar
- Bedenne L, Michel P, Bouché O, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol. 2007 Apr 1;25(10):1160-1168.Google Scholar
- Burmeister BH, Smithers BM, Gebski V, et al. Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial. Lancet Oncol 2005;6:659-668.Google Scholar
- Cooper JS, Guo MD, Herskovic A, et al. Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group. JAMA 1999;281:1623-1627.Google Scholar
- Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Eng J Med 2006;355(1):11-20.Google Scholar
- Herskovic A, Martz K, al-Sarraf M, et al. Combined chemotherapy and radiotherapy compared with radiotherapy alone in patients with cancer of the esophagus. N Engl J Med 1992;326:1593-1598.Google Scholar
- Minsky BD. Cancer of the Esophagus. In: Textbook of Radiation Oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 811-824.Google Scholar
- Stahl M, Wilke H, Lehmann M et al. Long-term results of a phase III study investigating chemoradiation with and without surgery in locally advanced squamous cell carcinoma (LA-SCC) of the esophagus. J Clin Oncol 26: 2008 ASCO abstract 4530.Google Scholar
- Swisher S, Winters K, Komaki R, et al. A phase II study of a paclitaxel based chemoradiation regimen with selective surgical salvage for resectable locoregionally advanced esophageal cancer: initial reporting of RTOG 0246. Int J Radiat Oncol Biol Phys 2007;69(3):S106).Google Scholar
- Czito BG, DiNittis AS, Willett CG. Esophageal Cancer. In: Halperin EC, Perez CA, Brady LW, et al., editors. Principles and Practice of Radiation Oncology. 5th ed: Lippincott Williams & Wilkins; 2007. pp. 1132-1153.Google Scholar
- Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med 2003;349:2241-2252.Google Scholar
- Minsky BD, Pajak TF, Ginsberg RJ, et al. INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol 2002;20:1167-1174.Google Scholar
- National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Esophageal Cancer. Available at: http://www.nccn.org/professionals/physician_gls/PDF/esophageal.pdf. Accessed on May 04, 2009.