Synoynme
esophageal carcinoma, esophageal tumor, esophageal tumor, esophageal – Ca, beret carcinoma
Definition
Esophageal cancer (esophagus) is a malignant, uncontrollably fast-growing tumor that originates from the cells of the esophageal mucosa. In 80-90% of cases, there is a connection between years of consumption of high-proof alcohol (alcohol abuse) and the consumption of cigarettes. Esophageal cancer can also develop from a beret esophagus, which is a consequence of reflux disease (chronic heartburn). The tumor causes symptoms only late, when it is already well advanced. Due to the late diagnosis, this type of cancer has a very poor prognosis for patients.
Tumor Stage
The tumor has already closed a large part of the esophagus diameter. This results in swallowing difficulties. The tumor stage is now determined by the above-mentioned diagnostics.
The tumor stage is decisive for the further planning of therapy. However, an exact assessment of the tumor stage is often only possible after the operation. The TNM classification is used to determine the tumor stage: The T stands for the tumor size and its expansion in the wall layers.
The N stands for the number of affected lymph nodes. The M stands for tumor metastases in other distant organs. All procedures are exemplary, the concrete procedure must always depend on the individual case of the patient.
Stage 0 = carcinoma in situThe cancer is only located in the uppermost cell layer and has not yet connected to the lymphatic system. The tumor is surgically removed (mucosal resection). Stage IThe tumor is limited to a small part of the esophagus.
It has not spread to neighbouring tissue, lymph nodes or even other organs. During the surgical procedure, part of the esophagus, in some cases the entire esophagus, is removed (esophagectomy). The lymph nodes are also removed.
The operation is followed by radiochemotherapy. Stage II The cancer has taken up large parts of the esophagus. It is possible that regional lymph nodes are already affected, but no other organs or tissues are affected yet.
Often treated like stage I stage IIIDcancer has spread to tissue or lymph nodes near the esophagus. However, it does not yet affect distant organs. Surgery is an attempt to remove the tumor with the aim of relieving pain and discomfort.
If the tumor is difficult to operate on, chemotherapy and radiation (radiochemotherapy) are administered before surgery to reduce the size of the tumor and make it more operable (neoadjuvant therapy). With this therapy it is possible to reduce the tumor stage (so-called downstaging). Stage IV cancer cells have already spread to other parts of the body and organs.
First, radiation is administered to reduce the tumor mass. Sometimes it is necessary to insert a stent into the esophagus. This stent is a kind of tube that keeps the oesophagus open. A partial removal of the tumor can be performed by laser or electricity (electroresection).
