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Malignant: Esophageal Cancers

  • Anthony Delliturri
  • Shintaro Chiba
  • Igor Brichkov
Chapter
Part of the Clinical Gastroenterology book series (CG)

Abstract

Worldwide, the incidence of new esophageal cancers is 440,000, and new deaths are 442,000 making esophageal cancer ranked ninth and sixth as the most common cancer and most frequent cancer-related cause of death, respectively. Esophageal carcinoma can be squamous cell carcinoma or adenocarcinoma, the latter increasing in frequency is North America and Europe. Obesity and reflux disease have been attributed to the cause.

Patients with esophageal cancer frequently present with dysphagia and weight loss. Once suspected, esophagography and endoscopy are diagnostic. Esophageal cancers are staged using endoscopic ultrasonography and computed tomography to assess for depth of invasion, nodal disease, and distant metastatic disease.

Early-stage esophageal cancers can be treated endoscopically avoiding the need for other modalities, while locoregionally advanced tumors require chemotherapy with radiation followed by surgery. Surgery requires esophagectomy and partial gastrectomy with replacement of the resected esophagus with a suitable tubularized replacement conduit, most commonly the stomach. Three methods of performing esophagectomy are described including the transhiatal, Ivor Lewis, and McKeown. Each technique has specific advantages and disadvantages, but preference for either technique is largely based on the surgeon preference.

Expectation, outcomes, and potential complications of esophageal surgery as well as rationale for various surgical techniques are discussed in detail.

Keywords

Minimally invasive esophagectomy Open esophagectomy Laparoscopy Esophageal cancer Minimally invasive surgery McKeown esophagectomy Ivor Lewis 

References

  1. 1.
    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.CrossRefGoogle Scholar
  2. 2.
    Global Burden of Disease Cancer Collaboration. The global burden of cancer 2013. JAMA Oncol. 2015;1(4):505–27.CrossRefGoogle Scholar
  3. 3.
    Zhang H-Z, Jin G-F, Shen H-B. Epidemiologic differences in esophageal cancer between Asian and Western populations. Chin J Cancer. 2012;31(6):281–6.CrossRefGoogle Scholar
  4. 4.
    Njei B, McCarty TR, Birk JW. Trends in esophageal cancer survival in United States adults from 1973 to 2009: a SEER database analysis. J Gastroenterol Hepatol. 2016;31(6):1141–6.CrossRefGoogle Scholar
  5. 5.
    Arnold M, Soerjomataram I, Ferlay J, Forman D. Global incidence of oesophageal cancer by histological subtype in 2012. Gut. 2015;64:381–7.CrossRefGoogle Scholar
  6. 6.
    Prabhu A, Obi KO, Rubenstein JH. The synergistic e ects of alcohol and tobacco consumption on the risk of esophageal squamous cell carcinoma: a meta-analysis. Am J Gastroenterol. 2014;109:822–7.CrossRefGoogle Scholar
  7. 7.
    Bosetti C, Gallus S, Garavello W, La Vecchia C. Smoking cessation and the risk of oesophageal cancer: an overview of published studies. Oral Oncol. 2006;42:957–64.CrossRefGoogle Scholar
  8. 8.
    Liu J, Wang J, Leng Y, Lv C. Intake of fruit and vegetables and risk of esophageal squamous cell carcinoma: A meta-analysis of observational studies. Int J Cancer. 2013;133:473–85.CrossRefGoogle Scholar
  9. 9.
    Lagergren J, Lagergren P. Recent developments in esophageal adenocarcinoma. CA Cancer J Clin. 2013;63:232–48.CrossRefGoogle Scholar
  10. 10.
    Spechler SJ, Souza RF. Barrett’s esophagus. N Engl J Med. 2014;371:836–45.CrossRefGoogle Scholar
  11. 11.
    Gibbs JF, Rajput A, Chadha KS, et al. The changing profile of esophageal cancer presentation and its implication for diagnosis. J Natl Med Assoc. 2007;99(6):620–6.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Chai J, Jamal MM. Esophageal malignancy: A growing concern. World J Gastroenterol. 2012;18(45):6521–6.CrossRefGoogle Scholar
  13. 13.
    Arnold M, Colquhoun A, Cook MB, Ferlay J, Forman D, Soerjomataram I. Obesity and the incidence of upper gastrointestinal cancers: an ecological approach to examine differences across age and sex. Cancer Epidemiol Biomarkers Prev. 2016;25(1):90–7.CrossRefGoogle Scholar
  14. 14.
    Levine MS, Chu P, Furth EE, Rubesin SE, Laufer I, Herlinger H. Carcinoma of the esophagus and esophagogastric junction: sensitivity of radiographic diagnosis. AJR Am J Roentgenol. 1997;168:1423–6.CrossRefGoogle Scholar
  15. 15.
    Rice TW, Blackstone EH, Rusch VW. A cancer staging primer: esophagus and esophagogastric junction. J Thorac Cardiovasc Surg. 2010;139:527–9.CrossRefGoogle Scholar
  16. 16.
    Desai RK, Tagliabue JR, Wegryn SA, Einstein DM. CT evaluation of wall thickening in the alimentary tract. Radiographics. 1991;11:771–83.CrossRefGoogle Scholar
  17. 17.
    Brierley JD, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. 8th ed. Hoboken: Wiley-Blackwell; 2016.Google Scholar
  18. 18.
    Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, Meyer L, Gress DM, Byrd DR, Winchester DP. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin. 2017;67:93–9.CrossRefGoogle Scholar
  19. 19.
    National Comprehensive Cancer Network. Esophageal cancer (Version 2.2017). https://www.nccn.org/professionals/physician_gls/pdf/esophageal
  20. 20.
    Pech O, May A, Manner H, Behrens A, Pohl J, Weferling M, Hartmann U, Manner N, Huijsmans J, Gossner L, Rabenstein T, Vieth M, Stolte M, Ell C. Long-term efficacy and safety of endoscopic resection for patients with mucosal adenocarcinoma of the esophagus. Gastroenterology. 2014;146(3):652–660.e1.CrossRefGoogle Scholar
  21. 21.
    Mariette C, Dahan L, Mornex F, et al. Surgery alone versus chemoradiotherapy followed by surgery for stage I and II esophageal cancer: nal analysis of randomized controlled phase III trial FFCD 9901. J Clin Oncol. 2014;32:2416–22.CrossRefGoogle Scholar
  22. 22.
    Yerokun BA, Sun Z, Yang CJ, Gulack BC, Speicher PJ, Adam MA, D’Amico TA, Onaitis MW, Harpole DH, Berry MF, Hartwig MG. Minimally invasive versus open esophagectomy for esophageal cancer: a population-based analysis. Ann Thorac Surg. 2016;102(2):416–23.  https://doi.org/10.1016/j.athoracsur.2016.02.078. Epub 2016 May 4.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Gurusamy KS, Pallari E, Midya S, Mughal M. Laparoscopic versus opentranshiatal oesophagectomy for oesophageal cancer. Cochrane Database Syst Rev. 2016;3:CD011390.PubMedGoogle Scholar
  24. 24.
    Yibulayin W, Abulizi S, Lv H, Sun W. Minimally invasive oesophagectomy versus open esophagectomy for resectable esophageal cancer: a meta-analysis. World J Surg Oncol. 2016;14(1):304.CrossRefGoogle Scholar
  25. 25.
    Guo W, Ma X, Yang S, Zhu X, Qin W, Xiang J, Lerut T, Li H. Combined thoracoscopic-laparoscopic esophagectomy versus open esophagectomy: ameta-analysis of outcomes. Surg Endosc. 2016;30(9):3873–81.  https://doi.org/10.1007/s00464-015-4692-x. Epub 2015 Dec 10.CrossRefPubMedGoogle Scholar
  26. 26.
    van der Sluis PC, Ruurda JP, van der Horst S, Verhage RJ, Besselink MG, Prins MJ, Haverkamp L, Schippers C, Rinkes IH, Joore HC, Ten Kate FJ, Koffijberg H, Kroese CC, van Leeuwen MS, Lolkema MP, Reerink O, Schipper ME, Steenhagen E, Vleggaar FP, Voest EE, Siersema PD, van Hillegersberg R. Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy versus open transthoracic esophagectomy for resectable esophageal cancer, a randomized controlled trial (ROBOT trial). Trials. 2012;13:230.CrossRefGoogle Scholar
  27. 27.
    Farge D, Bounameaux H, Brenner B, Cajfinger F, Debourdeau P, Khorana AA, Pabinger I, Solymoss S, Douketis J, Kakkar A. International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer. Lancet Oncol. 2016;17(10):e452–66.CrossRefGoogle Scholar
  28. 28.
    Raymondi R, Pereira-Lima JC, Valves A, Morales GF, Marques D, Lopes CV, Marroni CA. Endoscopic dilation of benign esophageal strictures without fluoroscopy: experience of 2750 procedures. Hepato-Gastroenterology. 2008;55(85):1342–8.PubMedGoogle Scholar
  29. 29.
    Luketich JD, Pennathur A, Awais O, Levy RM, Keeley S, Shende M, Christie NA, Weksler B, Landreneau RJ, Abbas G, Schuchert MJ, Nason KS. Outcomes after minimally invasive esophagectomy: review of over 1000 patients. Ann Surg. 2012;256(1):95–103.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Anthony Delliturri
    • 1
  • Shintaro Chiba
    • 1
  • Igor Brichkov
    • 2
  1. 1.Department of SurgeryMaimonides Medical CenterBrooklynUSA
  2. 2.Department of Surgery, Maimonides Medical CenterAlbert Einstein College of MedicineBrooklynUSA

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