Imaging for Esophageal Tumors
Robert J. Korst, MD and Nasser K. Altorki, MD
Carcinoma of the esophagus comprises the vast majority of malignant esophageal tumors and represents the seventh most common malignancy worldwide, with its incidence reaching endemic proportions in specific geographic locations in Asia and Africa . Although esophageal cancer is presently responsible for only approximately 13,000 deaths annually in the United States , the incidence of adenocarcinoma of the esophagus is rising faster than any other malignant tumor in the United States . Because the majority of patients present with advanced disease, only roughly 12% of patients diagnosed with this tumor will survive more than 5 years after diagnosis .
The treatment of carcinoma of the esophagus is stage-dependent (Table 1). While patients who have widely metastatic disease are not treated with curative intent (ie, only palliative chemotherapy or supportive care), most clinicians would agree that patients who have early (superficial, node-negative) cancers should undergo surgical resection for cure; however, the ideal treatment of locally advanced (transmural, node-positive) disease remains controversial, with some clinicians advocating surgical resection alone, others supporting preoperative neoadjuvant therapy followed by surgery, and still others backing definitive chemoradiation without surgery.