The esophagus (esophagus) is an organ located between the pharynx (pharynx) and the stomach and ensures that the food taken is taken to the stomach.
The incidence of esophageal cancer varies according to geographical regions. The most common types are squamous cell carcinoma and adenocarcinoma. While squamous cell carcinoma is more common in the Far East, adenocarcinoma is more common in developed countries. The disease is more common in eastern provinces in our country.
There are some risk factors for the development of esophageal cancer. Smoked foods, nitrite-containing foods (canned, pickled), smoking and alcohol use, consumption of very hot food, radiation, advanced age and male gender are known risk factors. Again, Barrett's esophagus (conversion of the cell structure to the stomach cell structure due to the destruction caused by reflux in the lower part of the esophagus) significantly increases the risk of adenocarcinoma.
In the same way, esophageal swallowing disorders, strictures (especially after corrosive substance ingestion), HPV infections increase the risk of cancer development.
Symptoms of esophageal cancer are dysphagia, weight loss, loss of appetite (anorexia), bleeding and environment. symptoms related to organ involvement. Due to the absence of the outer layer of the esophagus, symptoms usually occur late, and peripheral organ involvement is common.
The gold standard in the diagnosis of esophageal cancer is upper gastrointestinal endoscopy. A biopsy can be taken during the procedure. For staging, computed tomography is performed to evaluate local involvement, the status of lymph nodes and possible distant metastases. In doubtful cases, PET contributes. Endoscopic Ultrasonography (EUS) for staging has gained value in recent years.
Treatment in esophageal cancers is related to the stage of the tumor. At the same time, the treatment to be applied is related to the location of the tumor. The patient's age, health status, and extent of the disease also determine the treatment to be applied.
Approximately 8% of esophageal cancers are located in the cervical (neck) esophagus. Depending on the anatomical neighborhood of the region, larynx, main vessels or trachea (windpipe) involvement is common in tumors of this region. Radical surgery such as esophagolaryngectomy, stereotactic radiotherapy followed by chemotherapy can be used for treatment. .
Lymph node dissection should be performed together with resection in esophageal cancers. During surgery, a part of the stomach is also removed and the stomach is formed into a tube, the removed part is put in place and a new mouth is made.
In the presence of metastatic disease or surrounding organ involvement, palliative chemo-radiotherapy is applied. Stents can be placed in the esophagus to ensure swallowing. Laparoscopic feeding jejunostomy can be performed for patients who are not able to do so.
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