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

Jump to navigation Jump to search
No edit summary
 
(7 intermediate revisions by 3 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Esophageal cancer}}
{{Esophageal cancer}}
{{CMG}}{{AE}}m{{HM}}
{{CMG}}{{AE}};{{HM}}


==Overview==
==Overview==
Complications of esophageal cancer include dysphagia, anemia, and tracheoesophageal fistula. The incidence of esophageal dysplasia turning malignant is very low, especially outside the United States. 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, 2093 patients were screened endoscopically to record the natural history of esophageal cancer, from dysplasia to cancer.
 
*In total, 39 were diagnosed with severe dysplasia.
*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>
*Of the 39 severe dysplasia cases diagnosed by endoscopy, only 8 progressed to carcinoma with a mean time of 33.8 months and a median time of 30 months.
*If left untreated, patients with esophageal cancer may progress to develop [[Nausea and vomiting|vomiting]], [[aspiration pneumonia]] and [[hematemesis]].
*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.
*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]].
*The study concluded that severe dysplasia cases may have much lower carcinoma progression rate than other dysplasia 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>
*Ultimately, esophageal cancer can [[Metastasis|metastasize]] and be fatal.


==Complications==
==Complications==
Complications can occur as a product of esophageal cancer or because of radiotherapeutic treatment.
Complications can occur as a result 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 due to 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===
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>
* 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>
 
* 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>
 
{| style="cellpadding=0; cellspacing= 0; width: 600px;"
|-
| 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) 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>[[Image:5 year conditional relative survival of esophageal cancer.PNG|650x650px]]</figure-inline>


==References==
==References==

Latest revision as of 15:31, 5 February 2018

Esophageal cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Differentiating Esophageal cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Esophageal cancer natural history, complications and prognosis On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Esophageal cancer natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Esophageal cancer natural history, complications and prognosis

CDC on Esophageal cancer natural history, complications and prognosis

Esophageal cancer natural history, complications and prognosis in the news

Blogs on Esophageal cancer natural history, complications and prognosis

Directions to Hospitals Treating Esophageal cancer

Risk calculators and risk factors for Esophageal cancer natural history, complications and prognosis

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.


Template:WikiDoc Sources