For information purposes only

rose20
rose20 Member Posts: 258
edited October 2011 in Esophageal Cancer #1
For those who may not know how to navigate around on the computer for information.




Table 1




Current TNM staging of esophageal cancer.




TNM classification




T



Tis Carcinoma in situ



T1 Tumor invading lamina propria, muscularis mucosae, or submucosa



T2 Tumor invading muscularis propria



T3 Tumor invading periesophageal tissue



T4 Tumor invading adjacent structures




--------------------------------------------------------------------------------




N



N0 No regional lymph node metastases



N1 Regional lymph node metastases




--------------------------------------------------------------------------------




M



M0 No distant metastases



M1a Upper thoracic tumors metastatic to cervical nodes

Lower thoracic tumors metastatic to celiac nodes



M1b Other nonregional lymph node metastases or distant metastases



Stage groupings




--------------------------------------------------------------------------------




Stage 0 Tis N0 M0




--------------------------------------------------------------------------------




Stage I T1 N0 M0




--------------------------------------------------------------------------------




Stage IIA T2 N0 M0

T3 N0 M0




--------------------------------------------------------------------------------




Stage IIB T1 N1 M0

T2 N1 M0




--------------------------------------------------------------------------------




Stage III T3 N1 M0

T4 N0-1 M0




--------------------------------------------------------------------------------




Stage IVA T1-4 N0-1 M1a




--------------------------------------------------------------------------------




Stage IVB T1-4 N0-1 M1b


The April 15, 2011 release of the Cancer Statistics Review (1975-2008), and other statistics on the SEER web site, do not include cancer mortality statistics because the latest mortality file with 2008 deaths from the National Center for Health Statistics, Division of Vital Statistics has not been released. For this reason, the Cancer Statistics Review and Fast Stats currently do not include mortality statistics. Previous mortality data is still available through last year’s Cancer Statistics Review, the Stat Fact Sheets, as well as CanQues and SEER*Stat. Cancer mortality statistics will be posted as a later addendum to the Cancer Statistics Review and our other statistical reports and analysis tools when these data become available for use by the National Cancer Institute.

It is estimated that 16,640 men and women (13,130 men and 3,510 women) will be diagnosed with and 14,500 men and women will die of cancer of the esophagus in 2010
.

The following information is based on NCI’s SEER Cancer Statistics Review
From 2004-2008, the median age at diagnosis for cancer of the esophagus was 68 years of age3
. Approximately 0.0% were diagnosed under age 20; 0.3% between 20 and 34; 2.2% between 35 and 44; 11.9% between 45 and 54; 24.8% between 55 and 64; 27.6% between 65 and 74; 25.0% between 75 and 84; and 8.1% 85+ years of age.

Please go here to learn more:
http://seer.cancer.gov/statfacts/html/esoph.html#survival

Comments

  • rose20
    rose20 Member Posts: 258
    #2
    staging table
    If anyone knows of a more current TNM staging table please inform me and I will post it here. Thank you!
  • rose20
    rose20 Member Posts: 258
    #3
    rose20 said:

    staging table
    If anyone knows of a more current TNM staging table please inform me and I will post it here. Thank you!

    esophageal cancer From Wikipedia
    Esophageal cancer (or oesophageal cancer) is malignancy of the esophagus. There are various subtypes, primarily squamous cell cancer (approx 90-95% of all esophageal cancer worldwide) and adenocarcinoma (approx. 50-80% of all esophageal cancer in the United States). Squamous cell cancer arises from the cells that line the upper part of the esophagus. Adenocarcinoma arises from glandular cells that are present at the junction of the esophagus and stomach.[1]

    Esophageal tumors usually lead to dysphagia (difficulty swallowing), pain and other symptoms, and are diagnosed with biopsy. Small and localized tumors are treated surgically with curative intent. Larger tumors tend not to be operable and hence are treated with palliative care; their growth can still be delayed with chemotherapy, radiotherapy or a combination of the two. In some cases chemo- and radiotherapy can render these larger tumors operable. Prognosis depends on the extent of the disease and other medical problems...


    Esophageal cancers are typically carcinomas which arise from the epithelium, or surface lining, of the esophagus. Most esophageal cancers fall into one of two classes: squamous cell carcinomas, which are similar to head and neck cancer in their appearance and association with tobacco and alcohol consumption, and adenocarcinomas, which are often associated with a history of gastroesophageal reflux disease and Barrett's esophagus. A general rule of thumb is that a cancer in the upper two-thirds is a squamous cell carcinoma and one in the lower one-third is a adenocarcinoma.
  • rose20
    rose20 Member Posts: 258
    #4
    rose20 said:

    esophageal cancer From Wikipedia
    Esophageal cancer (or oesophageal cancer) is malignancy of the esophagus. There are various subtypes, primarily squamous cell cancer (approx 90-95% of all esophageal cancer worldwide) and adenocarcinoma (approx. 50-80% of all esophageal cancer in the United States). Squamous cell cancer arises from the cells that line the upper part of the esophagus. Adenocarcinoma arises from glandular cells that are present at the junction of the esophagus and stomach.[1]

    Esophageal tumors usually lead to dysphagia (difficulty swallowing), pain and other symptoms, and are diagnosed with biopsy. Small and localized tumors are treated surgically with curative intent. Larger tumors tend not to be operable and hence are treated with palliative care; their growth can still be delayed with chemotherapy, radiotherapy or a combination of the two. In some cases chemo- and radiotherapy can render these larger tumors operable. Prognosis depends on the extent of the disease and other medical problems...


    Esophageal cancers are typically carcinomas which arise from the epithelium, or surface lining, of the esophagus. Most esophageal cancers fall into one of two classes: squamous cell carcinomas, which are similar to head and neck cancer in their appearance and association with tobacco and alcohol consumption, and adenocarcinomas, which are often associated with a history of gastroesophageal reflux disease and Barrett's esophagus. A general rule of thumb is that a cancer in the upper two-thirds is a squamous cell carcinoma and one in the lower one-third is a adenocarcinoma.

    Signs & Symptoms
    Dysphagia (difficulty swallowing) and odynophagia (painful swallowing) are the most common symptoms of esophageal cancer. Dysphagia is the first symptom in most patients. Odynophagia may also be present. Fluids and soft foods are usually tolerated, while hard or bulky substances (such as bread or meat) cause much more difficulty. Substantial weight loss is characteristic as a result of reduced appetite and poor nutrition and the active cancer. Pain behind the sternum or in the epigastrium, often of a burning, heartburn-like nature, may be severe, present itself almost daily, and is worsened by swallowing any form of food. Another sign may be an unusually husky, raspy, or hoarse sounding cough, a result of the tumor affecting the recurrent laryngeal nerve.

    The presence of the tumor may disrupt normal peristalsis (the organized swallowing reflex), leading to nausea and vomiting, regurgitation of food, coughing and an increased risk of aspiration pneumonia. The tumor surface may be fragile and bleed, causing hematemesis (vomiting up blood). Compression of local structures occurs in advanced disease, leading to such problems as upper airway obstruction and superior vena cava syndrome. Fistulas may develop between the esophagus and the trachea, increasing the pneumonia risk; this condition is usually heralded by cough, fever or aspiration.[2]

    Most of the people diagnosed with esophageal cancer have late-stage disease. This is because people usually do not have significant symptoms until half of the inside of the esophagus, called the lumen, is obstructed, by which point the tumor is fairly large. [5]

    If the disease has spread elsewhere, this may lead to symptoms related to this: liver metastasis could cause jaundice and ascites, lung metastasis could cause shortness of breath, pleural effusions, etc.
  • rose20
    rose20 Member Posts: 258
    #5
    rose20 said:

    Signs & Symptoms
    Dysphagia (difficulty swallowing) and odynophagia (painful swallowing) are the most common symptoms of esophageal cancer. Dysphagia is the first symptom in most patients. Odynophagia may also be present. Fluids and soft foods are usually tolerated, while hard or bulky substances (such as bread or meat) cause much more difficulty. Substantial weight loss is characteristic as a result of reduced appetite and poor nutrition and the active cancer. Pain behind the sternum or in the epigastrium, often of a burning, heartburn-like nature, may be severe, present itself almost daily, and is worsened by swallowing any form of food. Another sign may be an unusually husky, raspy, or hoarse sounding cough, a result of the tumor affecting the recurrent laryngeal nerve.

    The presence of the tumor may disrupt normal peristalsis (the organized swallowing reflex), leading to nausea and vomiting, regurgitation of food, coughing and an increased risk of aspiration pneumonia. The tumor surface may be fragile and bleed, causing hematemesis (vomiting up blood). Compression of local structures occurs in advanced disease, leading to such problems as upper airway obstruction and superior vena cava syndrome. Fistulas may develop between the esophagus and the trachea, increasing the pneumonia risk; this condition is usually heralded by cough, fever or aspiration.[2]

    Most of the people diagnosed with esophageal cancer have late-stage disease. This is because people usually do not have significant symptoms until half of the inside of the esophagus, called the lumen, is obstructed, by which point the tumor is fairly large. [5]

    If the disease has spread elsewhere, this may lead to symptoms related to this: liver metastasis could cause jaundice and ascites, lung metastasis could cause shortness of breath, pleural effusions, etc.

    Increased Risk
    There are a number of risk factors for esophageal cancer.[2] Some subtypes of cancer are linked to particular risk factors:
    Age. Most patients are over 60, and the median in US patients is 67.[2]
    Sex. It is more common in men.
    Heredity. It is more likely in people who have close relatives with cancer.
    Tobacco smoking and heavy alcohol use increase the risk, and together appear to increase the risk more than either individually. Tobacco and/or alcohol account for approximately 90% of all esophageal squamous cell carcinomas. Tobacco smoking is also linked to esophageal adenocarcinoma though no scientific evidence has been found between alcohol and esophageal adenocarcinoma.
    Gastroesophageal reflux disease (GERD) and its resultant Barrett's esophagus increase esophageal cancer risk due to the chronic irritation of the mucosal lining. Adenocarcinoma is more common in this condition.[6]
    Human papillomavirus (HPV)[7]
    Corrosive injury to esophagus by swallowing strong alkalines (lye) or acids.
    Particular dietary substances, such as nitrosamine.
    A medical history of other head and neck cancers increases the chance of developing a second cancer in the head and neck area, including esophageal cancer.
    Plummer-Vinson syndrome (anemia and esophageal webbing)
    Tylosis and Howel-Evans syndrome (hereditary thickening of the skin of the palms and soles).
    Radiation therapy for other conditions in the mediastinum.[2]
    Coeliac disease predisposes towards squamous cell carcinoma.[8]
    Obesity increases the risk of adenocarcinoma fourfold.[9] It is suspected that increased risk of reflux may be behind this association.[6][10]
    Thermal injury as a result of drinking hot beverages[11][12]
    Alcohol consumption in individuals predisposed to alcohol flush reaction[13]
    Achalasia[14]
  • rose20
    rose20 Member Posts: 258
    #6
    rose20 said:

    Increased Risk
    There are a number of risk factors for esophageal cancer.[2] Some subtypes of cancer are linked to particular risk factors:
    Age. Most patients are over 60, and the median in US patients is 67.[2]
    Sex. It is more common in men.
    Heredity. It is more likely in people who have close relatives with cancer.
    Tobacco smoking and heavy alcohol use increase the risk, and together appear to increase the risk more than either individually. Tobacco and/or alcohol account for approximately 90% of all esophageal squamous cell carcinomas. Tobacco smoking is also linked to esophageal adenocarcinoma though no scientific evidence has been found between alcohol and esophageal adenocarcinoma.
    Gastroesophageal reflux disease (GERD) and its resultant Barrett's esophagus increase esophageal cancer risk due to the chronic irritation of the mucosal lining. Adenocarcinoma is more common in this condition.[6]
    Human papillomavirus (HPV)[7]
    Corrosive injury to esophagus by swallowing strong alkalines (lye) or acids.
    Particular dietary substances, such as nitrosamine.
    A medical history of other head and neck cancers increases the chance of developing a second cancer in the head and neck area, including esophageal cancer.
    Plummer-Vinson syndrome (anemia and esophageal webbing)
    Tylosis and Howel-Evans syndrome (hereditary thickening of the skin of the palms and soles).
    Radiation therapy for other conditions in the mediastinum.[2]
    Coeliac disease predisposes towards squamous cell carcinoma.[8]
    Obesity increases the risk of adenocarcinoma fourfold.[9] It is suspected that increased risk of reflux may be behind this association.[6][10]
    Thermal injury as a result of drinking hot beverages[11][12]
    Alcohol consumption in individuals predisposed to alcohol flush reaction[13]
    Achalasia[14]

    Decreased Risk
    Risk appears to be less in patients using aspirin or related drugs (NSAIDs).[15]
    The role of Helicobacter pylori in progression to esophageal adenocarcinoma is still uncertain, but, on the basis of population data, it may carry a protective effect.[16][17] It is postulated that H. pylori induces chronic gastritis, which is a risk factor for reflux, which in turn is a risk factor for esophageal adenocarcinoma.[18]
    According to the National Cancer Institute, "diets high in cruciferous (cabbage, broccoli/broccolini, cauliflower, Brussels sprouts) and green and yellow vegetables and fruits are associated with a decreased risk of esophageal cancer."[19]
    Moderate coffee consumption is associated with a decreased risk.[20]
    According to one Italian study of "diet surveys completed by 5,500 Italians"—a study which has raised debates questioning its claims among cancer researchers cited in news reports about it—eating pizza more than once a week appears "to be a favorable indicator of risk for digestive tract neoplasms in this population."[21]
  • Joel C
    Joel C Member Posts: 174
    #7
    rose20 said:

    Decreased Risk
    Risk appears to be less in patients using aspirin or related drugs (NSAIDs).[15]
    The role of Helicobacter pylori in progression to esophageal adenocarcinoma is still uncertain, but, on the basis of population data, it may carry a protective effect.[16][17] It is postulated that H. pylori induces chronic gastritis, which is a risk factor for reflux, which in turn is a risk factor for esophageal adenocarcinoma.[18]
    According to the National Cancer Institute, "diets high in cruciferous (cabbage, broccoli/broccolini, cauliflower, Brussels sprouts) and green and yellow vegetables and fruits are associated with a decreased risk of esophageal cancer."[19]
    Moderate coffee consumption is associated with a decreased risk.[20]
    According to one Italian study of "diet surveys completed by 5,500 Italians"—a study which has raised debates questioning its claims among cancer researchers cited in news reports about it—eating pizza more than once a week appears "to be a favorable indicator of risk for digestive tract neoplasms in this population."[21]

    Does anyone know at what TNM
    Does anyone know at what TNM stage is EC considered late stage? In Rose’s post she mentions “Most of the people diagnosed with esophageal cancer have late-stage disease.” I see this over and over on EC searches on the web but never have I seen it mentioned when the disease is actually considered late stage.
    Joel
  • NikiMo
    NikiMo Member Posts: 342
    #8
    Joel C said:

    Does anyone know at what TNM
    Does anyone know at what TNM stage is EC considered late stage? In Rose’s post she mentions “Most of the people diagnosed with esophageal cancer have late-stage disease.” I see this over and over on EC searches on the web but never have I seen it mentioned when the disease is actually considered late stage.
    Joel

    Agreed..what is late stage?
    Joel,

    I have been wondering the same thing, my husband has stage IIb, and I have wondered this whole time....is that early or late? One oncologist said that in my husbands case she thought this was "early intermediate stage"...umm...what? The thing with my huband is that he is T2N1, but the nodes are suscipicous. My husband had surgery last year for a hernia at that time there were two nodes measuring at 11x17 on a CT scan, the docs said it was due to the inflamation from the hernia. My husband was diagnosed with EC in May and another scan was done, the same nodes now measure 5X7, still large but smaller. They think those nodes may be cancerous becuase they are large hence the N1...but I asked our oncologist if cancer shrinks on it's own..he laughed and said we wish it would. So he said the nodes may or may not have cancer cells in them...also they didn't light up on the PET.CT scan. So in my hubands case I think they hope it is earlier then what they staged it at, but they are throwing the kitchen sink at it in case it's not. Better safe than sorry.

    So, I don't really have an answer. I could make an educated geuss on what is early, but I could be wrong, and no need to freak out everyone since I do not have MD anywhere near my name. I can just tell you what my husband's doc said.

    Niki
    Wife of Jeff T2N1M0
  • annalan
    annalan Member Posts: 138
    #9
    NikiMo said:

    Agreed..what is late stage?
    Joel,

    I have been wondering the same thing, my husband has stage IIb, and I have wondered this whole time....is that early or late? One oncologist said that in my husbands case she thought this was "early intermediate stage"...umm...what? The thing with my huband is that he is T2N1, but the nodes are suscipicous. My husband had surgery last year for a hernia at that time there were two nodes measuring at 11x17 on a CT scan, the docs said it was due to the inflamation from the hernia. My husband was diagnosed with EC in May and another scan was done, the same nodes now measure 5X7, still large but smaller. They think those nodes may be cancerous becuase they are large hence the N1...but I asked our oncologist if cancer shrinks on it's own..he laughed and said we wish it would. So he said the nodes may or may not have cancer cells in them...also they didn't light up on the PET.CT scan. So in my hubands case I think they hope it is earlier then what they staged it at, but they are throwing the kitchen sink at it in case it's not. Better safe than sorry.

    So, I don't really have an answer. I could make an educated geuss on what is early, but I could be wrong, and no need to freak out everyone since I do not have MD anywhere near my name. I can just tell you what my husband's doc said.

    Niki
    Wife of Jeff T2N1M0

    I stand to be corrected if
    I stand to be corrected if I'm wrong. But when my husband was diagnosed T3N1M0 I understood that a stage 3 and stage 4 were classed as advanced. But as most of us know stage 3 is operable but unfortunately stage 4 is not.
    Ann (2)
  • Joel C
    Joel C Member Posts: 174
    #10
    annalan said:

    I stand to be corrected if
    I stand to be corrected if I'm wrong. But when my husband was diagnosed T3N1M0 I understood that a stage 3 and stage 4 were classed as advanced. But as most of us know stage 3 is operable but unfortunately stage 4 is not.
    Ann (2)

    And here’s another one
    And here’s another one I’ve never gotten a straight answer on. My clinical stage was 2B (T2N1M0) the N1 vas verified with both a PET and fine needle aspiration biopsy. At pathology both the tumor site and involved node came back clean indicating a complete response to pre-surgery treatment. Does anyone know if the current survival rates are based on clinical or pathologic staging? I’ve asked several of my doctors but never get a straight answer. I always get some kind in-between answer. How the heck can that be, the stats have to be based on something?
    Joel
  • birdiequeen
    birdiequeen Member Posts: 319
    #11
    Joel C said:

    And here’s another one
    And here’s another one I’ve never gotten a straight answer on. My clinical stage was 2B (T2N1M0) the N1 vas verified with both a PET and fine needle aspiration biopsy. At pathology both the tumor site and involved node came back clean indicating a complete response to pre-surgery treatment. Does anyone know if the current survival rates are based on clinical or pathologic staging? I’ve asked several of my doctors but never get a straight answer. I always get some kind in-between answer. How the heck can that be, the stats have to be based on something?
    Joel

    The SEER (surveillance
    The SEER (surveillance Epidemiology and End Results) web site has a place where you can e-mail questions. They answered my question with a couple of days.
  • birdiequeen
    birdiequeen Member Posts: 319
    #12
    Joel C said:

    And here’s another one
    And here’s another one I’ve never gotten a straight answer on. My clinical stage was 2B (T2N1M0) the N1 vas verified with both a PET and fine needle aspiration biopsy. At pathology both the tumor site and involved node came back clean indicating a complete response to pre-surgery treatment. Does anyone know if the current survival rates are based on clinical or pathologic staging? I’ve asked several of my doctors but never get a straight answer. I always get some kind in-between answer. How the heck can that be, the stats have to be based on something?
    Joel

    The SEER
    You can find it under the "About SEER" tab and on the left is a contact us link.
  • Joel C
    Joel C Member Posts: 174
    #13
    birdiequeen said:

    The SEER
    You can find it under the "About SEER" tab and on the left is a contact us link.

    Thanks!
    Thank you Birdiequeen for the informative link. I sent a message to SEER asking about published survival rates Vs clinical & pathologic staging. When I receive an answer I’ll post it on this thread.
    Thanks again,
    Joel

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