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Review
. 2021 Feb 2;13(3):582.
doi: 10.3390/cancers13030582.

Epidemiology, Diagnosis, Staging and Multimodal Therapy of Esophageal and Gastric Tumors

Donelle Cummings  1 , Joyce Wong  2 , Russell Palm  3 , Sarah Hoffe  3 , Khaldoun Almhanna  4 , Shivakumar Vignesh  5
Affiliations
Review

Epidemiology, Diagnosis, Staging and Multimodal Therapy of Esophageal and Gastric Tumors

Donelle Cummings et al. Cancers (Basel). .

Abstract

Gastric and esophageal tumors are diverse neoplasms that involve mucosal and submucosal tissue layers and include squamous cell carcinomas, adenocarcinomas, spindle cell neoplasms, neuroendocrine tumors, marginal B cell lymphomas, along with less common tumors. The worldwide burden of esophageal and gastric malignancies is significant, with esophageal and gastric cancer representing the ninth and fifth most common cancers, respectively. The approach to diagnosis and staging of these lesions is multimodal and includes a combination of gastrointestinal endoscopy, endoscopic ultrasound, and cross-sectional imaging. Likewise, therapy is multidisciplinary and combines therapeutic endoscopy, surgery, radiotherapy, and systemic chemotherapeutic tools. Future directions for diagnosis of esophageal and gastric malignancies are evolving rapidly and will involve advances in endoscopic and endosonographic techniques including tethered capsules, optical coherence tomography, along with targeted cytologic and serological analyses.

Keywords: MALT lymphoma; esophageal cancer; gastric cancer; gastrointestinal stromal tumor; mucosal resection; neuroendocrine tumor; submucosal dissection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Barrett’s esophagus with Nodules White Light Endoscopy.
Figure 2
Figure 2
Barrett’s esophagus with nodules under narrow band imaging (NBI) (arrows).
Figure 3
Figure 3
T1a esophageal cancer in Barrett’s Esophagus.
Figure 4
Figure 4
Esophageal cancer endoscopic ultrasound (EUS) image T3.
Figure 5
Figure 5
Band-assisted mucosectomy.
Figure 6
Figure 6
Endoscopic Mucosal Rejection (EMR) T1 esophageal cancer; resection site.
Figure 7
Figure 7
Axial, coronal, and sagittal CT images demonstrating EUS-placed fiducial (red arrow) proximal to esophageal tumor.
Figure 8
Figure 8
Example radiotherapy plan for image-guided treatment with fiducial contoured (red arrow) and within the planning target volume (PTV).
Figure 9
Figure 9
High-definition white light endoscopy (HD-WLE) combined with optical chromoendoscopy techniques such as narrow-band imaging (NBI) and targeted biopsies.
Figure 10
Figure 10
EMR of Early Gastric Cancer (EGC); submucosa stained with methylene blue.
Figure 11
Figure 11
Early gastric cancer; EUS image polypoid lesion T1N0.
Figure 12
Figure 12
Gastrointestinal stromal tumor, as seen with high-definition white light endoscopy.
Figure 13
Figure 13
EUS images of a gastrointestinal stromal tumor originating from muscularis propria.
Figure 14
Figure 14
Gastric linitis plastica, submucosal infiltrating cancer; white light endoscopy.
Figure 15
Figure 15
EUS Linitis plastica with significant wall thickening.
See this image and copyright information in PMC

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