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Oesophageal Cancer
Aaron Hui
Introduction
•2 Main types (squamous and adenocarcinoma)
•Incidence of adenocarcinoma is rising
•3-4 / 100000 Western society
•Poor Prognosis
Pathophysiology
Chronic Mucosal irritation
•Genetic factors
•Environmental factors
Squamous Cell
Adenocarcinoma
Demographic and socioeconomic
factors
Gastroesophageal reflux disease
Smoking and alcohol
Smoking
Dietary factors
Alcohol
Underlying oesophageal disease
Obesity
Human papilloma virus
Helicobacter pylori infection
Bisphosphonates
Increased oesophageal acid exposure
Use of drugs that decrease lower
oesophageal sphincter pressure
Bisphosphonates
Barrett’s Eosophagus
Clinical presentation
-Dysphagia
-Weight loss
-Routine screening for Barrett’s
-Hoarseness
Distant metastasis
Paraneoplastic syndrome
Diagnosis
► Barium
Studies
► Gastroscopy
► CT,
PET
► EUS
Surgical Treatment
Gastric Cancer
Aaron Hui
Introduction
► Majority
adenocarcinoma
► 50% of people have locally advanced
disease at time of presentation
► 2 main types
► A proven infectious agent
Pathophysiology
►
Intestinal-type (well-differentiated)
Pre neoplastic cascade:
1. Non atrophic gastritis  2. Atrophic gastritis  3.
Intestinal Metaplasia  4. Dysplasia  5. Invasive
Carcinoma
Diffuse type (poorly differentiated)
- E-cadherin
►
Diagnosis
► Barium
studies
► Gastroscopy
► High resolution Helical Abdo CT
Surgical Treatment