Will esophageal cancer recur after resection?

Written by Luo Peng
Thoracic Surgery
Updated on September 14, 2024
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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.

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Esophageal cancer screening methods

The screening methods for esophageal cancer primarily involve checks of the esophagus, including upper gastrointestinal barium meal and gastroscopy. Gastroscopy, in particular, is a relatively accurate method for examining patients. This is because during a gastroscopy, biopsy samples can be taken, and pathology can definitively determine whether cancer is present. There might be issues regarding whether a patient can undergo a gastroscopy as it requires significant patient tolerance. Therefore, depending on the patient's health condition, if a gastroscopy is not feasible, an upper gastrointestinal barium meal can be conducted first.

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Esophageal cancer symptoms

In fact, the early symptoms of esophageal cancer are not very obvious. Some people only experience a slight discomfort when swallowing, and others might feel mild pain behind the sternum. However, in the advanced stages, the symptoms become more noticeable, such as progressive difficulty swallowing. Additionally, if the tumor compresses the laryngeal nerve, it can cause hoarseness. If it compresses the trachea, symptoms like shortness of breath and dry cough can occur. If the tumor erodes into the aorta, it can lead to severe bleeding.

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Oncology
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What are the symptoms of esophageal cancer recurrence?

The symptoms of recurrent esophageal cancer are similar to those at its initial onset, primarily characterized by difficulties in swallowing and eating obstructions. Some may also experience nausea, vomiting, and reflux symptoms of the digestive tract. Of course, when recurrence occurs, if there are metastases to other distant organs, then clinical manifestations corresponding to those metastatic locations will appear. For example, if esophageal cancer metastasizes to the lungs, it could lead to coughing, expectoration, shortness of breath, or chest pain, and even clinical symptoms related to coughing up blood. If there is liver metastasis from esophageal cancer, symptoms might include abdominal pain, fatigue, poor appetite, and even ascites among other clinical manifestations related to liver metastasis.

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Typical symptoms of esophageal cancer

The most typical symptom of esophageal cancer is progressive difficulty swallowing, and a progressive sensation of swallowing obstruction is the most typical symptom. It's actually quite simple; the esophagus is akin to a water pipe or a tubular cavity. Esophageal cancer is like having a tumor grow inside this cavity, similar to something blocking the pipe, which causes the flow of water to be impeded. However, not only water passes through this esophagus, but also food. Therefore, if there's something inside the cavity, both water and food cannot pass through, leading to this difficulty swallowing and discomfort while swallowing.

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Written by Peng Li Bo
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What are the precancerous lesions of esophageal cancer?

The most common precancerous lesion of esophageal cancer is Barret's esophagus, which is formed by the chronic stimulation of the esophageal epithelium by chronic reflux esophagitis. Of course, this includes some chronic esophageal ulcers and long-term leukoplakia of the esophagus. These recurrent esophageal ulcers could potentially transform into atypical hyperplasia and then further into carcinoma in situ. However, the progression from precancerous lesions to actual cancer can take a very long time, possibly many years or even over a decade. Therefore, having a precancerous lesion does not necessarily lead to esophageal cancer.