Saturday 8 September 2012

Oesophageal carcinoma

Oesophageal carcinoma

  • 40% squamous cell carcinomas
  • 60% adenocarcinomas
  • Prevalence: 10-15 / 100000 and increasing

Clinical features
  • Dysphagia
  • Progressive: Solids then liquids
  • Weight loss
  • Anorexia
  • Virchow's node in supraclavicular fossa

Investigations
  • Upper GI endoscopy and biopsy
  • Endoscopic ultrasound
  • CT to stage tumour (+ - PET)

Management
  • 10% 5 year survival
  • Squamous cell cancer
    • Radiotherapy + - chemotherapy
    • Surgery
  • Adenocarcinoma
    • Surgery
    • Palliative neo-adjuvant chemotherapy
    • Palliation: oesophageal stents to reduce dysphagia
    • Thermal ablation (endoscopically)
    • Radiotherapy

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