17. EPIDEMIOLOGY
• 6th leading cause of
cancer death
• 1% total malignancy
and 5-10% of GI
malignancy
• Most prevalent in Asia
& SE Asia.
• Most common
histological type-
Squamous Cell
Carcinoma &
Adenocarcinoma
20. BARRETTS
ESOPHAGUS
• Normal Squamous epithelium replaced by
Columnar epithelium
• Endoscopy should be performed on patients
with severe symptoms of GERD, family
history of Barrett’s esophagus or esophageal
cancer
• location, length, and circumferential
involvement should be characterized in
accordance with the Prague classification and
mucosal nodules should be carefully
documented.
21. BARRETTS
ESOPHAGUS
• Normal Squamous epithelium replaced by
Columnar epithelium
• Endoscopy should be performed on patients
with severe symptoms of GERD, family
history of Barrett’s esophagus or esophageal
cancer
• location, length, and circumferential
involvement should be characterized in
accordance with the Prague classification and
mucosal nodules should be carefully
documented.
33. PRINCIPALS OF
ENDOSCOPIC SATGING AND
THERAPY
• Diagnosis
• Staging
• Primary treatment
• Treatment of symptoms
• Follow up surveillance
34.
35. PET CT
• Can detect 15-20%
metastasis not
detected in CT and
EUS
• Low accuracy in
detecting nodal
disease
• Follow up response to
chemo & radiotherapy
57. PRINCIPLES OF
SURGERY• Clinical staging prior to surgery
• Tumor should be classified as per Siewarts classification
• Diagnostic Lap in Siewert II & III to assess occult mets
• In patients with advanced tumors, clinical T3 or N+ disease
should be considered for laparoscopic staging with peritoneal
washings.
• Cervical or cervicothoracic esophageal carcinomas <5 cm from
the cricopharyngeus: definitive chemoradiation.
• Resectable Esophageal Carcinoma
• Unresectable Esophageal Carcinoma
58. • Transthoracic Esophegectomy
• Ivor Lewis Approach(Rt
thoracotomy+Laparotomy+Thoracic Anastomosis)
• McKewon Approach(Rt
thoracotomy+Laparotomy+Cervical anastomosis)
• Transhiatal Esophagectomy
• Thoraco-abdominal Esophagectomy
• Minimally invasive Esophagectomy
PRINCIPLES OF
SURGERY