The epidemiology of esophageal cancer has marked variations in different areas of the world. The two major types are squamous cell carcinoma and adenocarcinoma; the latter entity has attracted much attention because of increasing prevalence in the Western nations. The major risk factors for adenocarcinoma include long-standing gastroesophageal reflux disease, Barrett’s metaplasia, and obesity. Risk factors for squamous cell carcinoma include alcoholism and smoking. Manifestations include dysphagia to solids and liquids, weight loss, and aspiration. Diagnosis requires upper endoscopy and target biopsies. Staging requires endoscopic ultrasound and CT imaging of chest and abdomen. Management includes surgery, chemotherapy, and radiation, based on location, stage, and type of cancer, in addition to consideration for age and comorbidities. New options for systemic therapy include targeted therapies and immunotherapy.
KeywordsObesity Adenocarcinoma Squamous cell carcinoma Esophageal Cigarette smoking and cancer Dysphagia Barrett’s metaplasia GERD
- Al-Batran S-E, et al. Perioperative chemotherapy with docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) versus epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/ECX) for resectable gastric or gastroesophageal junction (GEJ) adenocarcinoma (FLOT4-AIO): a multicenter, randomized phase 3 trial. J Clin Oncol. 2017;35:4004.CrossRefGoogle Scholar
- Du X, Hidayat K, Shi BM. Abdominal obesity and gastroesophageal cancer risk: systematic review and meta-analysis of prospective studies. Biosci Rep. 2017;37(3):BSR20160474Google Scholar
- Einzig AI, et al. Phase II trial of docetaxel (Taxotere) in patients with adenocarcinoma of the upper gastrointestinal tract previously untreated with cytotoxic chemotherapy: the eastern cooperative oncology group (ECOG) results of protocol E1293. Med Oncol. 1996;13(2):87–93.PubMedCrossRefGoogle Scholar
- Islami F, et al. A prospective study of tea drinking temperature and risk of esophageal squamous cell carcinoma. Int J Cancer. 2020;146(1):18–25.Google Scholar
- NIH. Cancer stat facts: esophageal cancer. 2019. https://seer.cancer.gov/statfacts/html/esoph.html. Accessed 8 Mar 2019.