Neoplasms of the Esophagus

Abstract

OverviewEsophageal cancer remains a leading cause of cancer deaths worldwide, sixth in men and ninth in women. In the past quarter century, esophageal cancer has changed from predominantly squamous‐cell carcinoma to adenocarcinoma, but only in North America and Europe. The concurrent increase in cancers of the gastroesophageal junction has led to its currently inclusion in the AJCC TNM (tumor, node, metastasis) staging of esophageal cancer. Treatment options have expanded to include endoscopic mucosal resection for early‐stage disease and neoadjuvant chemoradiation followed by surgery for intermediate stage disease. Surgical techniques have also evolved to include less invasive approaches using thoracoscopy and laparoscopy. Advances in systemic chemotherapy have also been reported, with the inclusion of hormonal and targeted therapies, for esophageal adenocarcinomas. A lethal disease when diagnosed in advanced stage, continued progress in therapeutic interventions can be anticipated with early‐stage detection in high‐risk patients, and the incorporation of molecular strategies in the treatment of advanced stage disease.