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Abstract
Cancer esophagus has the greatest variation in geographic distribution of any malignancy. It is the second common cause of cancer death in adult males. Like other malignancies, the etiology of cancer esophagus is still unclear; however, the following predisposing factors may be included: Barrett’s esophagus, achalasia, and esophageal diverticulae and webs.
Dysphagia and weight loss are the commonest presenting symptoms but may be presented with epigastric pain, regurgitation and vomiting. Cancer esophagus can be diagnosed in addition to clinical examination via barium esophagogram, esophagoscope, endoscopic ultrasound, CT-chest and other less significant measures.
Management of cancer esophagus today is very controversial. Nevertheless, it is still accepted that surgical treatment provides the best chance for cure, provided there is complete tumor removal, which is, so called Ro resection.
Radiotherapy as definitive therapy for cancer esophagus is still unclear but as preoperative adjuvant therapy for tumor shrinkage and postoperative for pathologically staged patients after esophagectomy.
The prognosis of patients with cancer esophagus depends on the state of the disease: the overall 5-year survival is between 15-25%, but this rate increase to between 40-80% for stage I and II cancers it seems that surgery has reached its limits; better results can be obtained only by earlier recognition of the disease and more effective adjuvant therapy.
From evidence of trials undergone, thus far implementing the multimodality approach of chemotherapy, radiation, and surgery we have reached a plateau. More controlled randomized studies are needed with the addition of new therapeutic drugs and schemes. It seems that this approach will be the method of the future for patients who can tolerate aggressive diseases.