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Esophageal carcinoma

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Esophageal carcinoma

  1. 1. UNIVERSIDAD DE GUADALAJARA Centro Universitario de Ciencias de la Salud Mancilla Corona Luis Antonio Dr. Benjamín Robles Mariscal Profesor: Dr. Héctor Manuel Virgen Ayala Guadalajara, Jalisco 21/SEP/2011 ESOPHAGEAL CARCINOMA
  2. 2. Epidemiology <ul><li>SQUAMOUS CARCINOMA </li></ul><ul><li>majority of esophageal carcinomas </li></ul><ul><li>ADENOCARCINOMA </li></ul><ul><li>70% </li></ul><ul><li>SARCOMAS and CARCINOSARCOMAS </li></ul><ul><li>0.1 - 1.5% </li></ul>
  3. 4. Etiology <ul><li>ADENOCARCINOMA </li></ul><ul><li>Metaplastic Barrett's mucosa </li></ul><ul><li>10-15% patients with GERD </li></ul><ul><li>Endoscopic surveillance </li></ul><ul><li>Resembles gastric cancer </li></ul><ul><li>SQUAMOUS CARCINOMA </li></ul><ul><li>Long-standing achalasia </li></ul><ul><li>Caustic injury </li></ul><ul><li>Smoking and alcohol consumption </li></ul><ul><li>Human papillomavirus </li></ul><ul><li>Plummer-Vinson syndrome </li></ul>
  4. 5. Clinical manifestations <ul><li>Dysphagia </li></ul><ul><li>Odynophagia </li></ul><ul><li>Anorexia and weight loss </li></ul><ul><li>Invaded tracheobronchial tree </li></ul><ul><li>Tracheoesophageal fistula </li></ul><ul><li>Invasion of the left recurrent laryngeal nerve </li></ul><ul><li>Systemic organ metastases </li></ul>
  5. 6. Image DX <ul><li>BARIUM SWALLOW </li></ul><ul><li>ENDOSCOPY </li></ul><ul><li>BRONCHOSCOPY </li></ul><ul><li>CT </li></ul><ul><li>PET </li></ul>
  6. 7. ADENOCARCINOMA SQUAMOUS CARCINOMA http://gastrointestinalatlas.com
  7. 9. Staging of esophageal carcinoma <ul><li>Wall penetration </li></ul><ul><li>Lymph node </li></ul><ul><li>distant organ Metastases </li></ul>WNM system
  8. 10. <ul><li>Staging of the primary tumor </li></ul><ul><li>according to the depth </li></ul><ul><li>of invasion </li></ul>
  9. 11. Clinical approach <ul><li>Curative surgical therapy </li></ul><ul><li>Palliative surgical therapy </li></ul><ul><li>Nonsurgical palliation </li></ul>based on LOCATION. AGE. HEALTH. EXTENT
  10. 12. Treatment <ul><li>SURGERY </li></ul><ul><li>endoscopic mucosal resection </li></ul><ul><li>transhiatal/transthoracic esophagectomy </li></ul><ul><li>en bloc esophagectomy </li></ul><ul><li>RADIATION THERAPY </li></ul><ul><li>CHEMOTHERAPY </li></ul>
  11. 15. ¡THANK YOU!

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