Disease Process

There may be no symptoms of esophagus cancer during the early stages. As the cancer develops, nonspecific symptoms occur, including dysphagia, weight loss, chronic cough, and pain in the retro-sternal, back, or right upper abdomen. In more than 50% of esophagus cancer cases, the cancer is either unresectable or has metastasized at the time of diagnosis. The prognosis of esophagus cancer depends on disease stages and tumor sizes. For resectable esophagus cancer, the 5-year survival rate ranges from 15 to 24%. For metastasized esophagus cancer, the 5-year survival rate is less than 5%.

Although both squamous cell carcinoma and ade-nocarcinoma of the esophagus are responsive to chemotherapy, the treatment effect rarely lasts more than 1 year. Radiotherapy may reduce the chance of perioperative morbidity and mortality, but it may increase the risk for local and regional complications such as esophagotracheal fistulas. Research is under way to determine whether an improved treatment efficacy can be achieved by combined chemotherapy, radiotherapy, and surgery.

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