Esophageal Cancer

Squamous cell carcinoma (SCCA) and adenocarcinoma represent the two most common histologic forms of esophageal cancer. These two tumor types differ significantly in terms of associated risk factors, response to therapy, and prognosis. Tobacco and alcohol consumption are associated risk factors for the development of squamous cell carcinoma. Adenocarcinoma is associated with obesity, race, age, and reflux disease. A precursor lesion for adenocarcinoma is Barrett's metaplasia, in which the normal squamous lining of the esophagus has been replaced by intestinal-type columnar cells in response to chronic gastroesophageal reflux disease. Yet, many patients with adenocarcinoma have no history of reflux, and have no evidence of metaplasia. Overall, survival for esophageal cancer is poor because the majority of patients are symptomatic at diagnosis and are found to have locally advanced to advanced disease stage.