Esophageal Cancer

Abstract

Esophageal cancers are malignancies that can arise along the entire length of the esophagus, from the cervical inlet to the gastroesophageal junction (GEJ). The most common histologic types are adenocarcinoma and squamous cell carcinoma, which account for almost 95% of esophageal cancers. The location of esophageal cancer varies by histology and strongly influences its behavior and treatment approach. The esophagus is divided into four distinct anatomic regions: the cervical, upper thoracic, midthoracic, and lower thoracic esophagus. Squamous cancers usually occur in the upper or middle esophagus. Adenocarcinomas are more commonly found in the lower third of the esophagus and in the GEJ of the stomach. This review of esophageal cancer addresses the epidemiology, etiology/genetics, pathophysiology and pathogenesis, diagnosis, differential diagnosis, treatment, complications, and prognosis. Figures show Siewert classification, age-standardized esophageal cancer incidence rates by sex and world area, endoscopic images of esophageal tumors, chemotherapy for metastatic esophageal cancer, and a management algorithm for localized esophageal cancer. Tables list hereditary cancer syndromes associated with esophageal cancer, differential diagnosis of dysphagia, physical examination findings in esophageal cancer, differential diagnosis of esophageal lesions seen on endoscopy, and prognosis by stage at diagnosis. This review contains 5 highly rendered figures, 5 tables, and 42 references.