Esophageal Cancer: An Updated Review

Michael DiSiena, MD; Alexander Perelman, DO; John Birk, MD; Houman Rezaizadeh, MD

Disclosures

South Med J. 2021;114(3):161-168. 

In This Article

Screening and Surveillance

Patients with certain risk factors should undergo screening endoscopies because of the notably higher prevalence of EC. Patients with lye-induced/caustic strictures are recommended to have at least biannual endoscopy 10 to 20 years after the insult.[101] Tylosis patients should begin biannual surveillance endoscopy at age 30.[101] Those with Peutz-Jeghers syndrome should have a baseline endoscopy (as well as colonoscopy and VCE) at age 8. If polyps are detected, then luminal surveillance should be repeated every 3 years; otherwise, continued surveillance can begin at age 18.[102] Although achalasia has an increased incidence of EC, surveillance endoscopies have not been shown to improve survival, so no formal recommendations exist.[101] Head and neck cancer patients and those with a long-term alcohol and tobacco abuse history have no formal guideline recommendations for surveillance endoscopy.

There are no guidelines regarding surveillance endoscopy following the resolution of EC because studies showing survival benefits are lacking. For example, one study looked at 518 esophageal AC patients treated with neoadjuvant chemoradiotherapy and studied them via endoscopy every 6 months for 18 months and then yearly after that. They found that only 2% of patients benefited from posttreatment surveillance.[103] Further studies need to be conducted to assess the most efficient means to monitor recurrence.

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