Esophageal cancer natural history, complications and prognosis: Difference between revisions
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==Overview== | ==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%. | 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== | ==Natural history== | ||
*From May 2012 to February 2014, patients were screened endoscopically to record the natural history of esophageal cancer, from dysplasia to cancer. | *From May 2012 to February 2014, patients were screened endoscopically to record the natural history of [[esophageal cancer]], from [[dysplasia]] to cancer. | ||
*Severe dysplasia cases diagnosed by endoscopy showed that only 5% had progressed to carcinoma. | *Severe [[dysplasia]] cases diagnosed by endoscopy showed that only 5% had progressed to carcinoma. | ||
*Excessively frequent endoscopy follow-up was found to waste medical resources and also lowered the compliance, while long, overdue follow-up intervals may cause unacceptable disease progression. | *Excessively frequent [[endoscopy]] follow-up was found to waste medical resources and also lowered the compliance, while long, overdue follow-up intervals may cause unacceptable disease progression. | ||
*The study concluded that cases with evidence of dysplasia cases have much lower carcinoma progression rate due to some cases remaining stable or due to the phenomenon of dysplasia reversal.<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> | *The study concluded that cases with evidence of [[dysplasia]] cases have much lower carcinoma progression rate due to some cases remaining stable or due to the phenomenon of [[dysplasia]] reversal.<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> | ||
==Complications== | ==Complications== | ||
Complications can occur as a product of esophageal cancer or because of radiotherapeutic treatment. | Complications can occur as a product of [[esophageal cancer]] or because of radiotherapeutic treatment. | ||
===Complications due to esophageal cancer=== | ===Complications due to esophageal cancer=== | ||
*Anemia | *[[Anemia]] | ||
*Weight loss | *[[Weight loss]] | ||
*Dysphagia | *[[Dysphagia]] | ||
*Cachexia | *[[Cachexia]] | ||
*Aspiration pneumonia | *[[Aspiration pneumonia]] | ||
*Metastases | *[[Metastasis|Metastases]] | ||
===Complications of radiotherapy=== | ===Complications of radiotherapy=== | ||
*Tracheoesophageal fistula | *[[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> | *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> | ||
==Prognosis== | ==Prognosis== | ||
===5-Year Survival=== | ===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> | * 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> | * 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> | ||
* The survival of patients with esophageal cancer varies with the stage of the disease. | * The survival of patients with esophageal cancer varies with the stage of the disease. | ||
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Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-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> | Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-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> | ||
<figure-inline><figure-inline><figure-inline>[[Image:5 year conditional relative survival of esophageal cancer.PNG|650x650px]]</figure-inline></figure-inline></figure-inline> | <figure-inline><figure-inline><figure-inline><figure-inline>[[Image:5 year conditional relative survival of esophageal cancer.PNG|650x650px]]</figure-inline></figure-inline></figure-inline></figure-inline> | ||
==References== | ==References== | ||
Revision as of 14:05, 20 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: mHadeel 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
- From May 2012 to February 2014, patients were screened endoscopically to record the natural history of esophageal cancer, from dysplasia to cancer.
- Severe dysplasia cases diagnosed by endoscopy showed that only 5% had progressed to carcinoma.
- Excessively frequent endoscopy follow-up was found to waste medical resources and also lowered the compliance, while long, overdue follow-up intervals may cause unacceptable disease progression.
- The study concluded that cases with evidence of dysplasia cases have much lower carcinoma progression rate due to some cases remaining stable or due to the phenomenon of dysplasia reversal.[1]
Complications
Complications can occur as a product of esophageal cancer or because of radiotherapeutic treatment.
Complications due to esophageal cancer
Complications of radiotherapy
- Tracheoesophageal fistula
- Postradiotherapy esophageal strictures, may lead to recurrent dysphagia.[2]
Prognosis
5-Year Survival
- Between 2004 and 2010, the 5-year relative survival of patients with esophageal cancer was 20%.[3]
- 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.[3]
- 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:[3]
| Stage | 5-year relative survival (%), (2004-2010) |
| All stages | 17.5% |
| Localized | 39.6% |
| Regional | 21.1% |
| Distant | 3.8% |
| Unstaged | 11.5% |
Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-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.[3]
<figure-inline><figure-inline><figure-inline><figure-inline>
</figure-inline></figure-inline></figure-inline></figure-inline>
References
- ↑ 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.
- ↑ 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.
- ↑ 3.0 3.1 3.2 3.3 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.