Oesphageal Cancer

Exam Cram

• Oesophageal cancer is an adenocarcinoma (distal third) and squamous cell carcinoma (proximal 2/3rds)

• Risk factors: Barret's oesphagus 

• Diagnosis: histology from biopsy

• Management options: radiofrequency ablation, Oesphagectomy, chemo/ radio/ immunotherapy, End of Life Care 

Outline

Background

• Histology: adenocarcinoma (distal third) and squamous cell carcinoma (proximal 2/3rds)

• Risk factors: Barrett's Oesphagus, Smoking, Alcohol

Assessment

History

• Progressive dysphagia to solids then liquids, insidious

• Weight loss, anorexia, 

• Smoker, alcohol excess

Examination

• Cachexic/ normal

• Rarely palpable mass within the oesphagus

Investigations

• Anaemia (normocytic)

• Mildly raised neutrophils, CRP, platelets, creatinine

Diagnosis

Diagnostic criteria: histology

Classification (severity): staging & TMN dictates management

Management

Surgery is the preferable modality

• T1, N1, M0- surgical resection

• T3-4, N1-3, M0- neoadjuvant chemo/radiotherapy with oesophagectomy

• T4, N3, M1- consider End of Life Care 

Resources and References

Links

• Physiology: GI system

• Pathology: Cancer

• Specialty: General Surgery, Gastroenterology

Written in 2025