Commonly Caucasian men in 50s
Risk Factors
Smoking
Alcohol
Barrett's Oesophagus
Aetiology
Commonly arises in areas of Barrett's Oesophagus
Associated with dysplastic epithelium
Progression from in-situ to invasive carcinoma less clear than SCC
Genetics: p53 gene mutation & chromosome 17p allele loss possibly involved tumour genesis
Ix
Distal oesophagus
Flat, ulcerating, infiltrative lesions
Classified as early/advanced tumours
Microscopy
Commonly intestinal-type differentiation
Less commonly gastric-type differentiation
* with mucus production
Clinical Course
* advanced at diagnosis, extending to surrounding structures, as tumours have to be large enough to produce dysphagia and local complications
Early Dx 5yr survivals = 75%
Overall 5yr survival = 5-10%
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