Do esophageal (esophagus) cancers progress slower?

From the Guidelines

Esophageal cancers do not typically progress slower than other cancer types; in fact, they often progress relatively quickly. Esophageal cancers are generally aggressive malignancies that can spread rapidly to nearby lymph nodes and other organs. The two main types of esophageal cancer—squamous cell carcinoma and adenocarcinoma—both tend to be diagnosed at later stages because early symptoms like difficulty swallowing usually appear only after the cancer has grown significantly.

• The 5-year survival rate for esophageal cancer is relatively low compared to many other cancers, around 20% overall, though this varies by stage at diagnosis 1.
• Early detection through screening for those at high risk (people with Barrett's esophagus, chronic acid reflux, heavy smoking or alcohol use) is crucial, as cancers caught at stage I have much better outcomes with survival rates of 40-50% 1.
• Treatment typically involves a combination of surgery, chemotherapy, and radiation therapy, with the specific approach depending on the cancer stage, location, and the patient's overall health 1.
• A recent study published in the Annals of Oncology in 2022 found that preoperative chemoradiation with carboplatin and paclitaxel significantly improved overall survival and disease-free survival compared to surgery alone in patients with resectable esophageal or EGJ cancers 1.
• The study also found that minimally invasive oesophagectomy (MIO) techniques, including robotics, have become increasingly implemented into clinical practice in recent years, with lower post-operative morbidity, quicker functional recovery, and better quality of life up to 1 year after surgery compared to open oesophagectomy 1. Therefore, based on the most recent and highest quality evidence, esophageal cancers should be treated with a combination of surgery, chemotherapy, and radiation therapy, and early detection through screening is crucial to improve outcomes.

From the Research

Esophageal Cancer Progression

• The progression of esophageal cancer can be influenced by various factors, including the type of treatment used 2, 3, 4, 5, 6.
• Studies have shown that different chemotherapy regimens, such as cisplatin/5-fluorouracil and carboplatin/paclitaxel, can have varying effects on the progression of esophageal cancer 2, 4.
• The use of radiotherapy, chemotherapy, and surgery in multimodal treatment approaches can also impact the progression of esophageal cancer 6.
• However, the evidence does not suggest that cancers that start in the esophagus progress slower than other types of cancer.

Treatment Outcomes

• Treatment outcomes for esophageal cancer can vary depending on the specific treatment approach used 2, 3, 4, 5, 6.
• Studies have reported improved overall survival and recurrence-free survival rates with certain treatment regimens, such as cisplatin/5-fluorouracil 2.
• However, other studies have found no significant difference in overall survival rates between different treatment approaches 4, 6.
• The effectiveness of treatment approaches can also depend on factors such as the stage of the cancer and the patient's overall health.

Chemotherapy Regimens

• Different chemotherapy regimens have been studied for the treatment of esophageal cancer, including cisplatin/5-fluorouracil and carboplatin/paclitaxel 2, 4.
• These regimens have been shown to have varying effects on treatment outcomes, including overall survival and recurrence-free survival rates 2, 4.
• The choice of chemotherapy regimen can depend on various factors, including the stage of the cancer and the patient's overall health.
• Further research is needed to determine the most effective chemotherapy regimens for the treatment of esophageal cancer.