How is esophageal cancer staged?

Written by Liu Liang
Oncology
Updated on February 16, 2025
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The staging of esophageal cancer includes a preoperative clinical staging and a postoperative pathological staging. Clinical staging involves completing various systemic examinations, determining the extent of the tumor, whether there are lymph node metastases, and whether there are distant metastases to organs such as the liver and lungs. This requires thorough assessments, including esophageal endoscopic ultrasound and whole-body examinations like PET-CT, to conduct clinical staging. Postoperative pathological staging, on the other hand, is determined based on the depth of tumor invasion reached during surgery and the status of lymph node metastasis, among other factors.

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What are the early symptoms of esophageal cancer?

The esophagus is a tubular passage for food, extending from the patient's pharynx to the stomach, thus named the esophagus. Its function is to allow food to travel from the mouth through the esophagus to the stomach. If a tumor develops in the esophagus, early symptoms can include difficulty swallowing, a choking sensation, and inability to swallow food, which sometimes may lead to vomiting. These are early symptoms of esophageal cancer. If the condition progresses to a late stage, it can lead to a situation where not even liquids can pass, making swallowing impossible, resulting in extreme weight loss. In severe cases, the cancer may metastasize, including to lymph nodes and other organs, and may also compress surrounding organs, causing symptoms like chest tightness.

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How long can one live with esophageal cancer?

The life expectancy of esophageal cancer patients depends on several factors such as the stage of the cancer at the time of diagnosis, the patient's sensitivity to treatments like radiotherapy and chemotherapy, the effectiveness of these treatments, the patient's general condition, and whether they have other underlying diseases. Patients who can undergo radical surgery, especially those diagnosed at an early stage, generally have a better prognosis. Patients who respond well to treatment can also expect a better outcome. Therefore, there is significant individual variation in prognosis.

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Distinction between esophagitis and esophageal cancer

Esophagitis and esophageal cancer are different diseases. Esophagitis refers to inflammatory changes in the esophagus, characterized by mucosal congestion, edema, and even erosion, commonly seen in middle-aged patients. Patients most often seek medical attention for abdominal discomfort or chest pain, and some may also experience nausea, belching, and so on. Esophageal cancer is more common in older patients, primarily presenting with progressively worsening dysphagia, accompanied by nausea, vomiting, and so on. Some cancer symptoms may be similar to those of esophagitis. The main method for differential diagnosis includes a thorough gastroscopic examination to provide further clarification. Esophagitis mainly manifests as inflammatory changes in the esophageal mucosa; in the case of esophageal cancer, a gastroscopic examination can directly reveal esophageal tumors, thereby facilitating differentiation.

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Early symptoms of esophageal cancer

The early symptoms of esophageal cancer are not very typical. In the early stages, there may be discomfort, a sensation of blockage, or burning and pinching feelings during swallowing. There might also be pain behind the breastbone. Other atypical gastrointestinal symptoms can include acid reflux, heartburn, belching, hiccups, and vomiting. However, as esophageal cancer progresses, the most typical symptom becomes difficulty swallowing, obstruction, and the sensation that swallowed items cannot pass down, including severe cases where even drinking water feels obstructed and leads to vomiting.

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Will esophageal cancer recur after resection?

This depends on the actual situation and the specific postoperative pathology of the patient. Generally, a comprehensive examination is conducted before esophageal cancer surgery, and surgery is only performed if there is no metastasis and the patient's physical condition permits it. Therefore, postoperatively, if it is very early-stage esophageal cancer, the likelihood of recurrence is generally small. However, if it involves mid-to-late stages, the possibility of recurrence must be considered. However, essentially, all cases of esophageal cancer are prone to recurrence after resection.