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Cancer of the Esophagus (cont.)

IN THIS ARTICLE

What is the prognosis for esophageal cancer?

When the esophageal cancer has spread to organs beyond the esophagus, long-term survival is uncommon.

The chance of recovery improves when doctors detect the cancer at an early stage. Five-year survival can exceed 50% for Stage 1 esophageal cancer. This drops to 20% in Stage 2, 10-15% in Stage 3, and is still essentially zero for Stage 4.

  • Once cancer invades the muscle layer of the esophagus, most people already have developed widespread cancer.
  • For these people, cancers invariably come back following surgical removal. Few people survive long term.
    • Following completion of therapy, whether with surgery, radiation, chemotherapy, or a combination of these, the patient needs regular follow-up endoscopic examinations as well as repeat CT scans of the chest and abdomen.
    • Often, people who undergo surgery of their esophagus develop significant narrowing at the site of the surgery. They require frequent esophageal dilatations or insertion of stents.

How is esophageal cancer diagnosed?

  • Reducing use of tobacco and alcohol can reduce the frequency of squamous cell carcinoma of the esophagus. Today it is recognized that HPV infection increases the risk of squamous cell carcinoma of the esophagus three-fold. HPV vaccination programs for young men and women can be expected to reduce the risk of this disease over time.
  • Adenocarcinoma of the esophagus is a frequent complication in Barrett's esophagus, which may be found in some people with symptoms of gastroesophageal reflux disease (GERD).
    • People with frequent symptoms of reflux (heartburn or regurgitation) should undergo screening with endoscopy.
    • People with Barrett's esophagus should have regular endoscopic tests to detect precancerous changes of the esophageal lining.
    • They also require tight control of the symptoms of gastroesophageal reflux, which may include dietary and lifestyle changes as well as medications and possible surgery, to prevent progression of Barrett;s esophagus.

The esophagus lies between the mouth and the stomach and serves as a conduit for food and liquids to the gastrointestinal tract.
The esophagus lies between the mouth and the stomach and serves as a conduit for food and liquids to the gastrointestinal tract.

Medically reviewed by Jay B. Zatzkin, MD; American Board of Internal Medicine with subspecialty in Medical Oncology

REFERENCES:

1. Adham M, Baulieux J, Mornex F, et al. Combined chemotherapy and radiotherapy followed by surgery in the treatment of patients with squamous cell carcinoma of the esophagus. Cancer. Sep 1 2000;89(5):946-54. [Medline].
2. Kelsen DP. Multimodality therapy of esophageal cancer: an update. Cancer J. Apr 2000;6 Suppl 2:S177-81. [Medline].
3. Lerut T, Coosemans W, De Leyn P, et al. Treatment of esophageal carcinoma. Chest. Dec 1999;116(6 Suppl):463S-465S. [Medline].
4. Reynolds JC, Waronker M, Pacquing MS, Yassin RR. Barrett's esophagus. Reducing the risk of progression to adenocarcinoma. Gastroenterol Clin North Am. Dec 1999;28(4):917-45. [Medline].
5. Stein HJ, Sendler A, Fink U, Siewert JR. Multidisciplinary approach to esophageal and gastric cancer. Surg Clin North Am. Apr 2000;80(2):659-82; discussions 683-6. [Medline].


Medically Reviewed by a Doctor on 6/3/2016
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Esophageal carcinoma was well described at the beginning of the 19th century, and the first successful resection was performed in 1913 by Frank Torek.

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