Squamous cell carcinoma and adenocarcinoma are the two main types of esophageal cancer. Squamous cell carcinoma makes up about 90% of cases and is usually located in the upper two-thirds of the esophagus. Adenocarcinoma is more common in Western countries and usually arises from Barrett's esophagus in the lower third. Risk factors include tobacco and alcohol use for squamous cell carcinoma and obesity and gastroesophageal reflux for adenocarcinoma. Both types often present with dysphagia and have poor prognosis due to advanced stage at diagnosis.
A brief description on Cholangiocarcinoma, its classification and management. Contains management of Intrahepatic cholangiocarcinoma, Perihilar cholangiocarcinoma, Distal cholangiocarcinoma.
Cholangiocarcinomas (bile duct cancers) arise from the epithelial cells of the intrahepatic and extrahepatic bile ducts.
Please do not edit or rename.
Note it is only for academic purposes.
This Presentation gives summarized overview of Gall Bladder Carcinoma especially the management as per latest National Comprehensive Cancer Network(NCCN) Guidelines version 2.2013
Sites of the highest risk are the duodenum, for adenocarcinomas, and the ileum, for carcinoids and lymphomas.
In industrialized countries, small bowel cancers are predominantly adenocarcinomas;
In developing countries, lymphomas are much more common.
The incidence of small bowel cancer rises with age and has generally been higher among males than among females.
The risk factors for small bowel cancer include
Dietary factor
Cigarette smoking,
Alcohol intake,
Medical conditions -Crohn's disease, familial adenomatous polyposis, cholecystectomy, peptic ulcer disease, and cystic fibrosis.
The protective factors may include rapid cell turnover, a general absence of bacteria, an alkaline environment, and low levels of activating enzymes of precarcinogens.
colorectal cancer, epidemiology, risk factors, sign and symptom,
pathophysiology, complications, assessment and diagnostic findings, medical and nursing interventions
A brief description on Cholangiocarcinoma, its classification and management. Contains management of Intrahepatic cholangiocarcinoma, Perihilar cholangiocarcinoma, Distal cholangiocarcinoma.
Cholangiocarcinomas (bile duct cancers) arise from the epithelial cells of the intrahepatic and extrahepatic bile ducts.
Please do not edit or rename.
Note it is only for academic purposes.
This Presentation gives summarized overview of Gall Bladder Carcinoma especially the management as per latest National Comprehensive Cancer Network(NCCN) Guidelines version 2.2013
Sites of the highest risk are the duodenum, for adenocarcinomas, and the ileum, for carcinoids and lymphomas.
In industrialized countries, small bowel cancers are predominantly adenocarcinomas;
In developing countries, lymphomas are much more common.
The incidence of small bowel cancer rises with age and has generally been higher among males than among females.
The risk factors for small bowel cancer include
Dietary factor
Cigarette smoking,
Alcohol intake,
Medical conditions -Crohn's disease, familial adenomatous polyposis, cholecystectomy, peptic ulcer disease, and cystic fibrosis.
The protective factors may include rapid cell turnover, a general absence of bacteria, an alkaline environment, and low levels of activating enzymes of precarcinogens.
colorectal cancer, epidemiology, risk factors, sign and symptom,
pathophysiology, complications, assessment and diagnostic findings, medical and nursing interventions
New Treatments for GERD and Barrett's EsophagusSummit Health
Learn the symptoms of Gastroesophageal Reflux Disease (GERD) and Barrett’s esophagus, and when they may warrant further medical attention. Hear the latest in treatment methods, including radio frequency ablation and endoscopic ultrasound.
Servikal İntraepitelyal Neoplazilerde (CIN) Yönetim nasıl olmalıdır?
HPV virüsü tipi takipte önemli midir? CIN1, CIN2 ve CIN3 te tedavi yöntemi ne olmalıdır?
This presentation summarizes the state of the art with respect to the management of GIST. It covers the basics of surgical and medical management including the role of neoadjuvant and adjuvant targeted therapy. www.ellenhornmd.com
CARCINOMA STOMACH
INCIDENCE
‘It is the captain of men of death’.
It is more common in Japan—70 per 1,00,000 population.
It is more common in males 2:1.
Decrease incidence in western world
esophageal carcinoma is one of the common gastrointestinal malignancy. Its usually present at advanced stage. Its management requires diagnosis as early as possible and staging followed by proper planning of treatment. Its treatment include endoscopic, surgical, adjuvant chemotherapy and palliative management.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
2. Carcinoma
• Malignant neoplasms of epithelial cell origin,
derived from any of the three germ layers,
are called carcinomas.
• Most esophageal tumors are
malignant, fewer than 1% are
benign.
3. Carcinoma of esophagus
Two morphologic variants :
Adenocarcinoma and
Squamous cell carcinoma.
• Worldwide, squamous cell carcinoma is more
common, but in the United States and other
Western countries adenocarcinoma is on the
rise. . A general rule of thumb is that a cancer in
the upper two-thirds is a squamous cell
carcinoma and one in the lower one-third is an
adenocarcinoma.
4. ADENOCARCINOMA
Adenocarcinoma denotes a lesion in which
the neoplastic epithelial cells grow in
glandular patterns.
Adenocarcinoma of the esophagus typically
arises in a background of Barrett esophagus
and long-standing GERD.
5. • Barrett esophagus is the only recognized precursor
of esophageal adenocarcinoma. The development
of AC from BE is a multistep
process that unfolds
many years.
6. The degree of dysplasia is the strongest
predictor of the progression to cancer.
Individuals with low –grade dysplasia have
very low rates of progression AC but the
progression to cancer may be 10% or more
per year in individuals with high grade
dysplasia.
7. •Overall, the risk for
developing AC varies from
30-fold to more than
100-fold above normal.
8. • In BE tissue there is increased cell
proliferation, and chromosomal
abnormalities become apparent in high-
grade dysplasia. Mutations in p53
progressively accumulate , and aneuploidy is
commonly found.
9. • Additional genetic abnormalities, such as
alterations in HER-2/NEU and beta catenin,
are present in the carcinomas but there are
no specific markers that precisely identify the
transition from high-grade dysplasia to cancer.
10. Risk of adenocarcinoma
Barrett esophagu
Age- over 60
Sex- more common in men
documented dysplasia
tobacco use,
obesity,
prior radiation therapy.
Obesity
Whites
11. Risk of adenocarcinoma is reduced by
• diets rich in fresh fruits and vegetables.
According to the National Cancer Institute,
"diets high in cruciferous (cabbage,
cauliflower,) and green and yellow vegetables
and fruits are associated with a decreased risk
of esophageal cancer.
12. • Moderate coffee consumption is associated with a
decreased risk.
• According to one Italian study eating pizza more than once
a week .
• Some Helicobacter pylori serotypes are associated
with a decreased risk of adenocarcinoma, perhaps by
causing gastric atrophy and reducing acid reflux (reduced
parietal cells).
• NSAID, particularly aspirin.
13. Epidemiology
• Esophageal adenocarcinoma occurs most
frequently in Caucasians and sevenfold more
common in men.
• Rates being highest in certain developed Western
countries, including the United States, the United
Kingdom, Canada, Australia, the Netherlands, and
Brazil and
• Lowest in Korea, Thailand, Japan, and Ecuador.
14. • In countries where esophageal adenocarcinoma
is more common, the incidence has
increased markedly since 1970, more
rapidly than almost any other cancer. As a
result, esophageal adenocarcinoma, which
represented less than 5% of esophageal cancers
before 1970, now accounts for halfof all
esophageal cancers in the United States.
15. Morphology
Esophageal adenocarcinoma usually occurs in
the distal third of the esophagus and
may invade the adjacent gastric cardia.
Initially appearing as flat or raised patches
in otherwise intact mucosa, large nodular
masses of 5 cm or more in diameter may
develop. Alternatively, tumors may infiltrate
diffusely or ulcerate and invade deeply.
16. • Microscopically, Barrett esophagus is frequently
present adjacent to the tumor.
• Tumors most commonly produce mucin and form
glands, often with intestinal-type morphology;
• less frequently tumors are composed of diffusely
infiltrative signet-ring cells (similar to those seen
in diffuse gastric cancers) or,
• in rare cases, small poorly differentiated cells
(similar to small-cell carcinoma of the lung).
18. • If the disease has spread elsewhere, this
may lead to symptoms related to this:
liver metastasis could cause jaundice and
ascites,
• lung metastasis could cause shortness of
breath, pleural effusions, etc.
21. Treatment
• The treatment is determined by the cellular type
of cancer (adenocarcinoma or squamous cell
carcinoma vs other types), the stage of the
disease, the general condition of the patient and
other diseases present. On the whole, adequate
nutrition needs to be assured, and adequate
dental care is vital
23. Follow-up
• Patients are followed up frequently after a
treatment regimen has been completed.
Frequently, other treatments are necessary to
improve symptoms and maximize nutrition.
24. Prognosis-Poor-dismal
• By the time symptoms appear, the tumor has
usually spread to submucosal lymphatic
vessels. As a result of the advanced stage at
diagnosis, overall 5-year survival is less than
25%(15%) with most patients dying within the
first year of diagnosis.
• In contrast, 5-year survival approximates
80% in the few patients with
adenocarcinoma limited to the mucosa or
submucosa.
25. Tylosis with esophageal cancer
A genetic disorder characterized by thickening
(hyperkeratosis) of the palms and soles, white patches in
the mouth (oral leukoplakia), and a very high risk of
esophageal cancer. This is the only genetic syndrome
known to predispose to squamous cell carcinoma of the
esophagus. The risk of developing esophageal cancer is
95% by age 70. The syndrome is inherited in an autosomal
dominant manner. The gene has been mapped to
chromosome 17q25 but has not been identified. The
syndrome is also called nonepidermolytic palmoplantar
keratoderma. The association of tylosis palmoplantaris with
esophageal cancer is called Howel-Evans syndrome.
26. Squamous cell carcinoma
Squamous cell carcinoma
a cancer in which the tumor
cells resemble stratified
squamous epithelium.
90% of esophageal cancer.
28. Risk factors of SCC of Esophagus
I. Esophageal disorders:
• Long standing esophagitis
• Achalasia
• Plummer-Vinson Syndrome
29. II. Life style:
•Alcohol
•Tobacco• An important contributing variable is retarded passage of food through the esophagus,
prolonging mucosal exposure to potential carcinogens such as those contained in tobacco and alcohol beverages.
• There is a well-defined predisposing role for chronic esophagitis, which is often the consequences of alcohol and
tobacco use.
30. III. Dietary:
• Def. of vit.
• Def. of trace metals
• Fungal contamination of food stuffs
• High content of nitrites/nitrosamines
• frequent consumption of very hot
beverages.
31. IV. Genetic predisposition:
• Tylosis
• Abnormalities affecting the p16/INK4 tumor suppressor gene and the
epidermal growth factor receptors are frequently present in SCC of the
esophagus. Mutation in p53 in 50% of these tumors.
32. V. Age. Over 45
VI. Sex. males four times more frequently than
females.
VII. Poverty
VII. Race- more common in blacks (6 times)
IX. Previous radiation therapy to the
mediastinum.
X. HPV
XI. Coeliac disease
33. • Esophageal squamous cell carcinoma
incidence varies up to 180-fold between and
within countries, being more common in
rural and underdeveloped areas.
• The regions with highest incidences are
• Iran, central China, Hong Kong, Brazil, and
South Africa.
34. Pathogenesis
The majority of esophageal squamous cell
carcinomas in Europe and the United States are at
least partially attributable to the use of alcohol
and tobacco, which synergize to increase risk.
35. • However, esophageal squamous cell
carcinoma is also common in some regions
where alcohol and tobacco use is
uncommon. Thus, nutritional deficiencies, as
well as polycyclic hydrocarbons,
nitrosamines, and other mutagenic
compounds, such as those found in fungus-
contaminated foods, must be considered.
36. • Human papillomavirus (HPV) infection has also
been implicated in esophageal squamous cell
carcinoma in high-risk areas but not in low-risk
regions.
• The molecular pathogenesis of esophageal
squamous cell carcinoma remains incompletely
defined, but loss of several tumor suppressor
genes, including p53 and p16/INK4a, is
involved.
38. • Early overt lesions appears as:
small, gray-white, plaquelike thickenings or
elevation of the mucosa.
• In months to years these lesions become
tumorous, taking one of three forms:
39. • 1. Polypoid exophytic masses that protrude
into the lumen.
• 2. Necrotizing cancerous ulceration that extend
deeply and sometimes erode into the respiratory
tree (Pneumonia), aorta (exsanguination)( or elsewhere.
• 3. Diffuse infiltrative neoplasm that cause
thickening and rigidity of the wall and narrowing of
the lumen.
40. • SCC arise about:
• 20% in the cervical& upper thoracic esophagus
50% in the middle third
• 30% in the lower third
43. Prognosis- dismal
• 5-year survival rates are 75% in individuals with
superficial esophageal carcinoma but much
lower in patients with more advanced tumors.
• Lymph node metastases, which are common,
are associated with poor prognosis.
• The overall 5-year survival
remains a dismal 9%.
44. Esophageal cancer. A, Adenocarcinoma usually occurs distally and, as
in this case, often involves the gastric cardia. B, Squamous cell
carcinoma is most frequently found in the mid-esophagus, where it
commonly causes strictures.