- Occurs most commonly in males (7:1)
- commonest site is mid oesophagus
- post-cricoid carcinoma in females as part of Plummer-Vinson syndrome
- Squamous cell - upper two thirds
- May get adenocarcinoma in lower third associated with Barrett's oesophagus
- Prognosis poor - most less than 6 months
Symptoms
- Dysphagia
- usually rapid onset
- solids before liquids
- Weight loss
- anorexia
- anaemia
- palpable supraclavicular nodes
- palpable irregular liver
Investigations
- FBC
- ESR
- U&Es
- LFTs
- Barium swallow
- Oesophagoscopy & biopsy
- CXR
- mediastinal widening
- secondaries in lung
- Bronchoscopy
- CT
- USS liver
Treatment
- Resection
- Ivor-Lewis operation
- suitable for middle and lower third tumours
- Stent
- Radiotherapy for squamous cell
carcinoma
Spread
- Local invasion
- Lymphatic to
- paraoesophageal
- supraclavicular
- abdominal
- Blood
Prognosis
- 5 year survival rate 5-6%
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