Carcinoma Esophagus

The two main subtypes of esophageal cancer are squamous cell carcinoma (SCC) and adenocarcinoma (EAC), each with distinct epidemiology, risk factors, and tumor biology. Dysphagia and weight loss are the most common presenting symptoms; advanced cases may exhibit aspiration, pain, or upper GI bleeding. Endoscopy with biopsy is the diagnostic gold standard; CT, PET-CT, and EUS are essential for comprehensive staging. Neoadjuvant therapy is standard for locally advanced esophageal cancer. Definitive chemoradiotherapy is the standard for cervical esophageal cancers and a nonsurgical option in patients unfit for surgery, particularly for SCC. Curative surgery remains central for resectable tumors. Choice of procedure depends on the tumor location: McKeown esophagectomy for mid/upper thoracic SCC and Ivor Lewis esophagectomy for distal EAC/GEJ tumors. D3 lymphadenectomy (N1–N3 nodes) is recommended, with a target of ≥15 lymph nodes for accurate staging. Minimally invasive and robotic-assisted esophagectomy (RAMIE) offers equivalent oncologic outcomes with reduced morbidity.