Esophageal Cancer

Esophageal cancers are grouped based on histologic features encompassing squamous cell carcinoma (SCC) and adenocarcinoma. In the past 3 decades, SCC has been decreasing while adenocarcinoma has been increasing in incidence in the United States (US). However, when stratified by anatomical location, the incidence of adenocarcinoma of the distal esophagus and gastroesophageal junction (GEJ) is actually increasing due to the Barrett esophagus. In the US, gastroesophageal cancers represent the fourth most common gastrointestinal cancer after colorectal, pancreatic, and hepatobiliary cancers and have the third-highest mortality rate.

Common sites of disseminated disease include the liver, lungs, distant lymph nodes, bones, and peritoneum. Carcinomatosis is common and seen in approximately 10% to 15% of those with esophageal and esophagogastric junction (EGJ) adenocarcinomas, particularly those with diffuse or mixed-type histology or tumors with signet-ring features. This condition results in the formation of ascites and abdominal pain, ultimately leading to severe anorexia, dysfunctional bowel, and frank partial or complete bowel obstruction.