Last reviewed: June 2019
Last updated: August  2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • dysphagia
  • odynophagia
  • weight loss
Full details

Other diagnostic factors

  • hoarseness
  • hiccups
  • postprandial/paroxysmal cough
Full details

Risk factors

  • male sex
  • tobacco use (squamous cell carcinoma)
  • alcohol use (squamous cell carcinoma)
  • GORD and Barrett's oesophagus (adenocarcinoma)
  • hiatus hernia (adenocarcinoma)
  • FHx of oesophageal, stomach, oral, or pharyngeal cancer (squamous cell carcinoma)
  • low socioeconomic status
  • non-white race (squamous cell carcinoma)
  • high-temperature beverages and foods (squamous cell carcinoma)
  • drinking maté (squamous cell carcinoma)
  • low intake of fresh fruit and vegetables
  • obesity (adenocarcinoma)
  • human papillomavirus (squamous cell carcinoma)
  • achalasia (squamous cell carcinoma)
  • glyceryl trinitrate, anticholinergics, beta-adrenergics, aminophyllines, benzodiazepines (adenocarcinoma)
  • vitamin and mineral deficiencies (squamous cell carcinoma)
  • poor oral hygiene
Full details

Diagnostic investigations

1st investigations to order

  • oesophagogastroduodenoscopy (OGD) with biopsy
  • comprehensive metabolic profile
Full details

Investigations to consider

  • CT thorax and abdomen
  • MRI thorax and abdomen
  • FDG-PET scan
  • endoscopic ultrasound (EUS) ± fine needle aspiration (FNA)
  • bronchoscopy ± fine needle aspiration (FNA)
  • thoracoscopy and laparoscopy
  • pulmonary function tests
  • cardiac stress test
  • echocardiogram
Full details

Treatment algorithm

ACUTE

stage 0 and stage IA

stage IB and stage IIA

stage IIB and stage III

stage IV

Contributors

Authors VIEW ALL

Mark J. Krasna

Cancer Institute of New Jersey System Partnership Leader

Oncology Service Line

Meridian Health

Neptune

NJ

Disclosures

MJK is an author of several references cited in this monograph.

Ghulam Abbas

Director

Minimally invasive Thoracic Surgery Meridian Health

Meridian Health System

Red Bank

NJ

Disclosures

GA declares that he has no competing interests.

Peer reviewers VIEW ALL

Clinical Reader in Surgery

Nuffield Department of Surgery

University of Oxford

Oxford

UK

Disclosures

PM declares that he has no competing interests.

Assistant Professor of Oncology

Roswell Park Cancer Institute

Buffalo

NY

Disclosures

NIK has received funding for the conduction of clinical trials and associated translational studies from Merck, Pfizer, and Astra-Zeneca. NIK has a grant from the National Comprehensive Cancer Network (from research support by Roche).

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