Cancer of the esophagus

A number of recent reports have provided insight into the pathogenesis, staging, and treatment of esophageal cancer. Human papillomavirus can be carcinogenic in squamous epithelium, and more than 20% of esophageal squamous cell tumors have been found to be infected with the virus. The frequency of adenocarcinoma of the esophagus and esophagogastric junction continues to rise in the United States and Europe. Recent reports suggest that these tumors may arise from short, unrecognized segments of intestinal metaplasia that occur commonly at the esophagogastric junction. New studies confirm that endosonography is the best available imaging technique for assessing the depth of tumor invasion and the presence of regional lymph nodes. Several investigations have focused on chemoradiotherapy, a promising, but toxic, new treatment for esophageal cancer, and on biomarkers that might be used to tailor therapy for affected patients. Although cancers of the thoracic esophagus that involve the cervical lymph nodes traditionally have been considered incurable, two recent studies have challenged this contention.