Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus. The esophagus is a muscular tube that moves food and liquids from the throat to the stomach. The most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma begins in flat cells lining the esophagus. Adenocarcinoma begins in cells that make and release mucus and other fluids.
The most common presenting symptom of esophageal cancer is dysphagia. Esophagogastroduodenoscopy allows direct visualization and biopsies of the tumor, while endoscopic ultrasonography is the most sensitive test for determining the depth of penetration of the tumor and the presence of enlarged periesophageal lymph nodes. In patients who appear to have localized esophageal cancer, positron emission tomography (PET) scanning may be useful as part of the baseline staging. Other imaging studies may be valuable in selected patients.
The ideal treatment for localized esophageal cancer is sometimes debated across practice cultures and subspecialties. Defendants of surgical treatment argue that resection is the only treatment modality to offer curative intent; defendants of the nonsurgical approach claim that esophagectomy has a prohibitive index of mortality and that esophageal cancer is an incurable disease.
Esophageal cancer is the seventh leading cause of cancer death worldwide. In some regions, the incidence of esophageal carcinoma may be as high as 800 cases per 100,000 population.