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Principles and Procedures > Esophageal Cancer > Flashcards

Esophageal Cancer Flashcards

(72 cards)

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1
Q

What is the 5 year survival rate for esophageal cancer?

A

20% (whites), 15% (blacks)

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2
Q

African americans are 50% higher risk than whites for esophageal cancer. True or false?

A

True

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3
Q

Esophageal cancer is how many times more prevalent in males?

A

3 times

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4
Q

What is the common age of occurrence for esophageal cancer?

A

55-85 yo

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5
Q

What are contributing factors to the occurrence of esophageal cancer in China, Iran, and South Africa?

A

Diet and Environment

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6
Q

What are contributing factors to the occurrence of esophageal cancer in North America and Western Europe?

A

Excessive tobacco and alcohol use

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7
Q

What are some other contributing factors to esophageal cancer?

A

cleaning product ingestion, low fruit and veggie diets, and drinking hot liquids

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8
Q

What is achalasia?

A

occurs when the lower 2/3 of the esophagus loses peristaltic activity. Esophagus dilates and sphincter constricts

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9
Q

What is the risk of esophageal cancer with having achalasia?

A

5-20%

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10
Q

What is Barrett’s esophagus?

A

squamous epithelium changes to columnar epithelium, typically caused by GE reflux.

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11
Q

What is metaplasia?

A

constant changing of mucosa

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12
Q

What histology is associated with barretts esophagus?

A

Adenocarcinoma

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13
Q

75% of esophageal cancer occurs in what portion of the esophagus?

A

Distal esophagus

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14
Q

What is Plummer Vinson syndrome?

A

Iron deficient anemia causes changes to the esophagus, such as webbing atrophic glottis

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15
Q

What histology is Plummer Vinson syndrome risk for?

A

small cell carcinoma

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16
Q

What is tylosis?

A

an inherited genetic disorder that is characterized as excessive growth of hands and feet

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17
Q

What percentage of individuals experiencing tylosis develop SCC?

A

40%

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18
Q

What are the prognostic factors of esophageal cancer?

A

Tumor size, Weight loss greater than 10%, Poor karnofsky, and pt over 65 yo

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19
Q

Histology or grade has prognostic importance in esophageal cancer. True or False?

A

False

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20
Q

What does an esophageal tumor size greater than 5 cm indicate?

A

Distant mets 75% of the time

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21
Q

How long is the esophagus?

A

25 cm long

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22
Q

Where is the esophagus located within the body?

A

Posterior to trachea and anterior to vertebral bodies

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23
Q

Where does the esophagus penetrate the diaphragm?

A

Esophageal hiatus

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24
Q

What is the measurement from the incisor to the cervical esophagus?

A

18 cm

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25
What is the measurement from the incisor to the upper esophagus?
24 cm
26
What is the measurement from the incisor to the middle esophagus?
32 cm
27
What is the measurement from the incisor to the distal esophagus?
40 cm
28
What body landmarks signify the cervical esophagus?
Cricoid process to the thoracic inlet
29
What body landmarks signify the upper esophagus?
Suprasternal notch to the tracheal bifurcation
30
What body landmarks signify the middle esophagus?
Carina to proximal to EG junction
31
What body landmarks signify the distal esophagus?
mid distal distance to EG junction
32
What is the function of the esophagus? (2 answers)
Secret mucous, transport food
33
Movement of food from the laryngopharynx to the esophagus is regulated by what structure?
esophageal sphincter
34
What is the involuntary movement of the esophageal called?
Peristalsis
35
What LN are included in the Cervical esophagus? (3)
Internal jugular, cervical and supraclavicular
36
What LN are included in the upper esophagus? (5)
subcarinal, paraesophageal, paratracheal, mediastinal, hilar
37
What LN are included in the lower esophagus? (3)
Celiac axis and gastric, nodes of curvature
38
What is the clinical presentation of esophageal cancer?
Dysphagia and weight loss
39
What is odynophagia?
Painful swallowing
40
What are some symptoms of advanced esophageal cancer?
Hematemesis, hemoptysis, Hoarseness
41
Fistulas can occur when the esophagus abnormally separates and fuses to the trachea. True or False?
True
42
What are some detection methods of esophageal cancer? (4)
CT, CBC, Bronchoscopy, Endoscopic Ultrasound
43
What occurs during an endoscopic ultrasound?
A transducer is sent down the esophagus and a signal is sent out to which an ultrasound detects the waves during a scan
44
What is the predominant histology of esophageal cancer?
Adenocarcinoma
45
What are top 2 sites of metastasis of esophageal cancer?
Liver and Lung
46
What is the survival rate based off of Stage 0 esophageal cancer?
greater than 90
47
What is the survival rate based off of Stage 1 esophageal cancer?
greater than 70
48
What is the survival rate based off of Stage 2A esophageal cancer?
15-30%
49
What is the survival rate based off of Stage 2B esophageal cancer?
10-30%
50
What is the survival rate based off of Stage 3 esophageal cancer?
less than 10%
51
What is the survival rate based off of Stage 4 esophageal cancer?
rare
52
What is the preferred tx method for esophageal cancer?
surgery alone but rarely possible
53
What are the two most common tx technique for esophageal cancer?
Definitive chemo-radiotherapy, Neoadjuvant preoperative chemoradiotherapy
54
What are the surgical techniques used for esophageal cancer?
Subtotal or total esophagectomy
55
What is a gastric pull-up in esophageal surgery?
Stomach or left colon placed in thoracic cavity
56
What are the characteristic of esophageal cancer needed for curative resection?
limited to esophagus, no nodule involvement and medically fit
57
What are the characteristic of esophageal cancer needed for palliative resection?
distant mets, nodule mets, extension outside esophagus
58
What are some complication of esophageal cancer surgery? (5)
Anastomatic leak, respiratory failure, pulmonary embolus, myocardial infarct, stricture reflux
59
What is the dose restriction in radiation therapy alone for esophageal cancer?
65 Gy
60
What is the dose restriction in chemo-radiation therapy for esophageal cancer?
50 Gy
61
What is the set up for esophageal cancer?
Supine, arms up, immobilized, chin up, SSD Check
62
What are the characteristics of the RT treatment fields for esophageal cancer?
Ports large due to potential of spread, included primary + 3-4 cm below GTV
63
What is the superior border for esophageal cancer tx fields?
Sup - thyroid cartilage, inf - carina
64
What nodes are typically included in esophageal tx fields?
S'clav, Lower cervical, and Med. nodes
65
What is the standard technique of RT when treating esophageal cancer? Include RT types. (6)
AP/PA, 45 off the cord (3DCRT, IMRT, VMAT, PROTONS)
66
What are some side effects of esophageal cancer?
Esophagitis, food sticking and dysphagia, ulceration, N/V
67
What is the dose restriction on the esophagus?
65 Gy, 50 Gy when with chemo
68
What is the TD 5/5 of the heart?
50 Gy
69
What is the TD 5/5 of the spinal cord?
45 Gy
70
What is the TD 5/5 of the lung?
30 Gy
71
What is the TD 5/5 of the Liver?
less than 3%
72
What is the TD 5/5 of the kidney?
less than 20 Gy, other must be shielded

Principles and Procedures (27 decks)

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