Squamous Cell Carcinoma, Esophagus

Abstract

Esophageal cancer, according to GLOBOCAN 2018 data, ranks seventh in terms of incidence and sixth in mortality among all cancers worldwide. In India, it is considered the fourth most common cause of cancer-related deaths. Influenced by lifestyle, socioeconomic and environmental factors, striking geographic variations in incidence exist. With regard to histopathology, esophageal cancers are unique among malignancies of the gastrointestinal tract in that they principally comprise two variants: squamous cell carcinoma (SCC) and adenocarcinoma, with the former accounting for up to 80% of cases. Etiological factors for SCC show marked variations worldwide, with tobacco consumption, alcohol, hot beverages, and poor nutrition constituting the predominant predisposing factors. Although present day therapeutic interventions have begun to positively influence disease prognosis, with significant improvements in survival noted over the last 3 decades, cancer of the esophagus remains a highly lethal disease with a case fatality rate approaching 90%. Management of this disease includes all three primary modalities of treatment; surgery, chemotherapy and radiotherapy. Surgical resection, the only curative modality of treatment, remains a challenge even with advances like minimal access surgery and is feasible only in early stage disease. Early diagnosis and accurate staging are paramount for optimizing treatment and hence, prognosis.