Esophageal cancer - barium swallow

A review of the clinical records from 1947 to 1984 of the Istituto Nazionale Tumori of Milan provided 20 cases (14 males and 6 females) of esophageal leiomyoma. Eighteen of the tumors were in the thoracic esophagus and 2 were at the cardiac level. The most frequent symptoms were dysphagia, slight epigastralgia and odynophagia. Differential diagnosis should be made with mediastinic neoplasms and esophageal cancer. Barium swallow and esophagoscopy are the most sensitive procedures for a correct preoperative diagnosis. Surgery is mandatory because of the tendency to a continuous endoluminal growth (in 97% of the cases) and a possible malignant transformation. However, surgery is conservative: extramucosal enucleation of the leiomyoma is the procedure of choice. The long-term results are excellent, and morbidity is acceptable.

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Dose Intensified Chemoradiation and Intraluminal Brachytherapy Improve Outcomes in Middle Third Carcinoma Esophagus: Experience from a Regional Cancer Center

Asian Journal of Oncology ◽

10.1055/s-0040-1708113 ◽

2020 ◽

Vol 6 (02) ◽

pp. 61-64

Author(s):

Tanvirpasha C. R. ◽

Siddanna R. P. ◽

Bindu V. ◽

Naveen T. ◽

Lokesh V.

Keyword(s):

Esophageal Cancer ◽

Disease Free Survival ◽

External Beam Radiation ◽

Cancer Center ◽

Barium Swallow ◽

Second Primary ◽

Actuarial Survival ◽

Beam Radiation ◽

Intraluminal Brachytherapy ◽

Carcinoma Esophagus

Abstract Introduction Esophageal cancer is known for its poor outcome despite multimodality treatment. In this study, we report our experience with concurrent capecitabine-based chemoradiotherapy followed by intraluminal brachytherapy (ILBT) for middle third esophageal cancer. Materials and Methods Twenty patients of histology-proven middle third esophageal cancer were treated with 45 Gray (Gy)/25 fraction (fr) of external beam radiation on telecobalt using two-dimensional technique with concurrent cisplatin 40 mg/m2 weekly with five such cycles along with tablet capecitabine 825 mg/m2 twice daily for the first 2 weeks and last 2 weeks of radiotherapy. This was followed by ILBT of 4 Gy × 3 fr placed 1 week apart from a total biologically effective dose of 60 Gy. Patients were followed up with clinical examination and serial barium swallow to assess response and toxicity. Results Out of 20 patients, disease-free survival at 2 years was 60%. At 5 years, the actuarial survival was 47% with five patients alive and two patients lost to follow-up at 3 years. One patient had grade 3 toxicity in the form of tracheoesophageal fistula (5%). Two patients had distal failure. Two patients had second primary tumor in the upper aerodigestive tract at the end of 7 years. Conclusion A combination of chemotherapy with cisplatin and capecitabine given concurrently with radical radiation therapy followed by ILBT boost is a safe and feasible protocol in the treatment of carcinoma esophagus involving middle third of esophagus. The local control and survival are comparable to historical studies with minimal toxicity.

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Nonsurgical management of esophageal cancer: report of a study of combined radiotherapy and chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.1987.5.11.1783 ◽

1987 ◽

Vol 5 (11) ◽

pp. 1783-1790 ◽

Cited By ~ 72

Author(s):

L R Coia ◽

P F Engstrom ◽

A Paul

Keyword(s):

Esophageal Cancer ◽

Mitomycin C ◽

Squamous Cell ◽

Oral Candidiasis ◽

Cell Cancer ◽

Eastern Cooperative Oncology Group ◽

Definitive Treatment ◽

Barium Swallow ◽

High Dose

Between October 1980 and December 1985, 50 patients with esophageal cancer were treated with combined radiotherapy and chemotherapy (5-fluorouracil [5-FU] and mitomycin C). Thirty patients with stage I or II disease received definitive treatment consisting of 6,000 cGy in 6 to 7 weeks and 5-FU (1,000 mg/m2/24 h) as a continuous intravenous (IV) infusion for 96 hours, starting on days 2 and 29. Mitomycin C (10 mg/m2) was administered as a bolus injection on day 2. Twenty patients received palliative treatment (5,000 cGy plus chemotherapy) for stage III or IV disease (extraesophageal spread or distant metastases). All patients treated in this program had an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2. Of the 30 definitively treated patients, 23 had squamous cell cancer, while seven had adenocarcinoma. Follow-up ranged from 6 months to 63 months. The complete response rate at 1 to 3 months following completion of treatment was 87% (26 of 30) documented by barium swallow and endoscopy (+/- biopsy). The actuarially determined local relapse-free rate at 1 year and beyond was 73%, and the actuarial survivals at 1, 2, and 5 years were 68%, 47%, and 32%, respectively. Of the 20 palliatively treated patients, ten had squamous cell carcinoma, eight had adenocarcinoma, and two had undifferentiated carcinoma. Seventeen patients were evaluable for freedom from dysphagia 1 or more months following completion of treatment. Eighty-two percent of evaluable patients (14 of 17) had no dysphagia posttreatment, while 64% (11 of 17) remained free of dysphagia until death or last follow-up, emphasizing the significant local control of those patients. The median survival for this group was 8 months. Treatment was well tolerated, and acute toxicity included esophagitis, stomatitis, oral candidiasis, and hematologic toxicities of thrombocytopenia and neutropenia. Late toxicities were predominantly manifested as a mild to moderate benign stricture, which required dilatation in four patients. One patient developed a perforation into the mediastinum in the absence of tumor, while two patients with persistent local disease developed tracheoesophageal fistula, and radiation pneumonitis was observed in two patients. This combination of radiation therapy with infusional 5-FU and mitomycin C is an effective and relatively well-tolerated regimen in the treatment of esophageal cancer. Surgical resection may not be necessary when high-dose radiation and chemotherapy are used.

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Galimybės nustatyti stemplės vėžio išplitimą prieš operaciją

Lietuvos chirurgija ◽

10.15388/lietchirur.2005.1.2327 ◽

2005 ◽

Vol 3 (1) ◽

pp. 0-0

Author(s):

Paulius Gradauskas ◽

Romaldas Rubikas

Keyword(s):

Computed Tomography ◽

Esophageal Cancer ◽

Esophageal Carcinoma ◽

Clinical Stage ◽

Preoperative Staging ◽

Preoperative Assessment ◽

Esophageal Resection ◽

Barium Swallow ◽

Abdominal Ultrasonography ◽

N Staging

Paulius Gradauskas, Romaldas RubikasKauno medicinos universiteto Torakalinės chirurgijos klinika,Eivenių g. 2, LT-50009 KaunasEl paštas: [email protected] Įvadas / tikslas Operacinį stemplės vėžio gydymą galima planuoti tik jeigu tikimasi atlikti R0 rezekciją. Tyrimo tikslas – įvertinti priešoperacinių paciento tyrimų galimybes nustatyti stemplės vėžio klinikinę stadiją (cTNM). Ligoniai ir metodai Perspektyviuoju būdu analizuoti 62 pacientų, kuriems dėl vėžio buvo atliktos stemplės rezekcijos ir dviejų arba trijų laukų limfadenektomijos, duomenys. Klinikinė stadija (cTNM) buvo nustatyta atlikus ezofagoskopiją, rentgenokontrastinį stemplės tyrimą, kaklo ir pilvo ultragarsinį tyrimą ir kaklo, krūtinės bei pilvo viršutinio aukšto kompiuterinę tomografiją. Šio kompleksinio klinikinio ištyrimo rezultatai lyginami su patologine ligos stadija (pTNM), nustatyta patologiniu morfologiniu pašalintų organų komplekso tyrimu. Rezultatai Priešoperacinio tyrimo jautrumas, specifiškumas ir bendras tikslumas buvo atitinkamai 22,2%, 96,2% ir 85,5% vertinant vietinį; 41,7%, 80,8% ir 58,1% vertinant sritinį; 33,3%, 98,2% ir 91,9% vertinant tolimą naviko išplitimą. Išvada Klinikiniu tyrimu pakankamai tiksliai įvertinamos tolimos stemplės vėžio metastazės, tačiau tiek lokalus, tiek sritinis naviko išplitimas – nepakankamai. Reikšminiai žodžiai: stemplės vėžys, naviko stadija, diagnostika, kompiuterinė tomografija, stemplės rentgenokontrastinis tyrimas Possibilities of preoperative staging of esophageal cancer Paulius Gradauskas, Romaldas RubikasClinic of Thoracic Surgery, Kaunas University of Medicine,Eivenių str. 2, LT-50009 Kaunas, LithuaniaE-mail: [email protected] Background / objective Only in case of performing R0 esophageal resection it is reasonable to plan surgical treatment of esophageal cancer. The aim of this study was to evaluate the possibilities of preoperative noninvasive staging of esophageal carcinoma. Patients and methods Sixty-two patients were examined prospectively before esophageal resection with 2-field or 3-field lymphadenectomy performed due to cancer. The investigation consisted of esophagoscopy, barium swallow, cervical and abdominal ultrasonography, cervical, chest and upper abdominal computed tomography. The clinical stage (cTNM) was compared to pathomorphological one (pTNM). Results The sensitivity and specificity of preoperative assessment were, respectively, 22.6 and 96.2 percent in T staging; 41.7 and 80.8 percent in N staging; and 33.3 and 98.2 percent in M staging. Conclusion The accuracy of the preoperative staging of esophageal carcinoma is sufficient in M staging, but too low in T and N staging. Keywords: esophageal carcinoma, preoperative staging, computed tomography, barium swallow, diagnostics

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Routine Barium Swallow May Be Unnecessary after Resection of Esophageal Cancer

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2015.07.347 ◽

2015 ◽

Vol 221 (4) ◽

pp. S145 ◽

Cited By ~ 1

Author(s):

Andreas Andreou ◽

Ben Struecker ◽

Matthias Biebl ◽

Johann Pratschke

Keyword(s):

Esophageal Cancer ◽

Barium Swallow

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Considerations in Dysphagia Management Following Esophagectomy

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig13.169 ◽

2016 ◽

Vol 1 (13) ◽

pp. 169-176

Author(s):

Lisa M. Evangelista ◽

James L. Coyle

Keyword(s):

Esophageal Cancer ◽

Minimally Invasive ◽

Minimally Invasive Surgical Procedures ◽

Esophageal Resection ◽

Minimally Invasive Surgical ◽

Operative Complications ◽

Swallowing Difficulties ◽

Epidemiological Impact ◽

Invasive Techniques ◽

Management Of Dysphagia

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Esophageal resection is the mainstay treatment for cancers of the esophagus. While curative, surgical resection may result in swallowing difficulties that require intervention from speech-language pathologists (SLPs). Minimally invasive surgical procedures for esophageal resection have aimed to reduce morbidity and mortality associated with more invasive techniques. Both intra-operative and post-operative complications, regardless of the surgical approach, can result in dysphagia. This article will review the epidemiological impact of esophageal cancers, operative complications resulting in dysphagia, and clinical assessment and management of dysphagia pertinent to esophageal resection.

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