Esophageal cancer natural history, complications and prognosis: Difference between revisions

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{{Esophageal cancer}}
{{Esophageal cancer}}
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==Overview==
==Overview==
==Natural History==
The incidence of esophageal dysplasia turning malignant is very low, especially outside the United States. Complications of esophageal cancer include [[dysphagia]], [[anemia]], and [[tracheoesophageal fistula]]. This finding has caused some uncertainty as to the usefulness of screening. Esophageal cancer is associated with a 5 year survival rate of 20%.
 
==Natural history==
 
*The symptoms of esophageal cancer typically develop insidiously and starts with symptoms such as [[dysphagia]], [[chest pain]] and [[weight loss]].<ref name="pmid28465681">{{cite journal |vauthors=Wang JW, Guan CT, Wang LL, Chang LY, Hao CQ, Li BY, Lu N, Wei WQ |title=Natural History Analysis of 101 Severe Dysplasia and Esophageal Carcinoma Cases by Endoscopy |journal=Gastroenterol Res Pract |volume=2017 |issue= |pages=9612854 |year=2017 |pmid=28465681 |pmc=5390561 |doi=10.1155/2017/9612854 |url=}}</ref>
*If left untreated, patients with esophageal cancer may progress to develop [[Nausea and vomiting|vomiting]], [[aspiration pneumonia]] and [[hematemesis]].
*Depending on the degree of invasion both [[squamous cell carcinoma]] or [[adenocarcinoma]] can cause rupture of the esophagus, which can manifest as [[hematemesis]], [[melena]] and severe [[chest pain]].
*Ultimately, esophageal cancer can [[Metastasis|metastasize]] and be fatal.
 
==Complications==
==Complications==
==Prognosis==
Complications can occur as a result of [[esophageal cancer]] or because of radiotherapeutic treatment.
===5-Year Survival===
* Between 2004 and 2010, the 5-year relative survival of patients with esophageal cancer was 20 %.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>


* When stratified by age, the 5-year relative survival of patients with esophageal cancer was 19.8 % and 15.5 % for patients <65 and ≥ 65 years of age respectively.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>
===Complications due to esophageal cancer===


* The survival of patients with esophageal cancer varies with the stage of the disease.  Shown below is a table depicting the 5-year relative survival by the stage of esophageal cancer:<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>
*[[Anemia]]
*[[Weight loss]]
*[[Dysphagia]]
*[[Cachexia]]
*[[Aspiration pneumonia]]
*[[Metastasis|Metastases]]


{| style="cellpadding=0; cellspacing= 0; width: 600px;"
===Complications due to radiotherapy===
|-
|style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 10%" align=center |'''Stage'''|| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 10%" align=center | '''5-year relative survival (%), (2004-2010)'''
|-
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''All stages'''|| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | 17.5%
|-
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Localized'''|| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left  | 39.6%
|-
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Regional'''|| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | 21.1%
|-
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left  |'''Distant'''|| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left  | 3.8%
|-
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left  |'''Unstaged'''|| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | 11.5%
|}


Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 1998 and 2010 of esophageal cancer by stage at diagnosis according to [[SEER]]. These graphs are adapted from [[SEER]]: The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>
*[[Tracheoesophageal fistula]]
*Postradiotherapy esophageal strictures, may lead to recurrent [[dysphagia]].<ref name="pmid2452006">{{cite journal |vauthors=O'Rourke IC, Tiver K, Bull C, Gebski V, Langlands AO |title=Swallowing performance after radiation therapy for carcinoma of the esophagus |journal=Cancer |volume=61 |issue=10 |pages=2022–6 |year=1988 |pmid=2452006 |doi= |url=}}</ref>


[[Image:5 year conditional relative survival of esophageal cancer.PNG|5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) by stage at diagnosis according to SEER]]
==Prognosis==
Prognosis is generally poor, and the 5-year survival rate of patients with esophageal cancer is approximately 20% for both [[squamous cell carcinoma]] and [[adenocarcinoma]] of the esophagus.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>


==References==
==References==
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Oncology]]


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Latest revision as of 15:31, 5 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: ;Hadeel Maksoud M.D.[2]

Overview

The incidence of esophageal dysplasia turning malignant is very low, especially outside the United States. Complications of esophageal cancer include dysphagia, anemia, and tracheoesophageal fistula. This finding has caused some uncertainty as to the usefulness of screening. Esophageal cancer is associated with a 5 year survival rate of 20%.

Natural history

Complications

Complications can occur as a result of esophageal cancer or because of radiotherapeutic treatment.

Complications due to esophageal cancer

Complications due to radiotherapy

Prognosis

Prognosis is generally poor, and the 5-year survival rate of patients with esophageal cancer is approximately 20% for both squamous cell carcinoma and adenocarcinoma of the esophagus.[3]

References

  1. Wang JW, Guan CT, Wang LL, Chang LY, Hao CQ, Li BY, Lu N, Wei WQ (2017). "Natural History Analysis of 101 Severe Dysplasia and Esophageal Carcinoma Cases by Endoscopy". Gastroenterol Res Pract. 2017: 9612854. doi:10.1155/2017/9612854. PMC 5390561. PMID 28465681.
  2. O'Rourke IC, Tiver K, Bull C, Gebski V, Langlands AO (1988). "Swallowing performance after radiation therapy for carcinoma of the esophagus". Cancer. 61 (10): 2022–6. PMID 2452006.
  3. Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.


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