Introduction Two most common forms of esophageal cancer include squamous cell carcinoma most commonly seen in the upper 2/3 of the esophagus risk factors include EtOH, smoking, achalasia, Plummer-Vinson adenocarcinoma located at the lower 1/3 of the esophagus (GE junction) most commonly a sequelae of Barrett's esophagus Presentation Symptoms dysphagia weight loss back pain chest pain hoaseness Evaluation Possible initial diagnostic test: barium swallow UGI localizes tumor Most accurate test: EGD to obtain biopsy and assess respectability TEU (transesophageal ultrsound) CT scan for metastatic workup Stage Tumor Nodes 5-year Stage I Tumor invades lamina propia or submucosa Neg 80% Stage IIa Tumor invades muscularis propia or adventitia Neg 33% Stage IIb Tumor invades up to muscularis propia Pos 33% Stage III Tumor invades adventitia Pos 15% Stage III Tumor invades adjacent structure Neg 15% Stage IV Distant mets 0% Treatment Total thoracic esophagectomy with gastric pull-up or colon interposition (+/- chemotherapy) Prognosis and Complications Post operative mortality of 5%