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Inicio Radiología (English Edition) Esophageal cancer: Anatomic particularities, staging, and imaging techniques
Journal Information
Vol. 58. Issue 5.
Pages 352-365 (September - October 2016)
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Vol. 58. Issue 5.
Pages 352-365 (September - October 2016)
Update in Radiology
Esophageal cancer: Anatomic particularities, staging, and imaging techniques
Cáncer de esófago: particularidades anatómicas, estadificación y técnicas de imagen
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1175
J. Encinas de la Iglesiaa,
Corresponding author
javiencinas@yahoo.es

Corresponding author.
, M.A. Corral de la Callea, G.C. Fernández Pérezb, R. Ruano Pérezc, A. Álvarez Delgadod
a Servicio de Radiodiagnóstico, Complejo Asistencial de Ávila, Ávila, Spain
b Servicio de Radiodiagnóstico, Hospital Universitario Río Hortega, Valladolid, Spain
c Servicio de Medicina Nuclear, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
d Servicio de Aparato Digestivo, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
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Tables (3)
Table 1. Comparison between the 6th and 7th editions of TNM classification. In bold on the right column the changes introduced in the actual categorization are shown.
Table 2. MR study acquisition protocol used in our center for esophageal cancer.
Table 3. Utility of the different imaging modalities to determine anatomic characteristics for the clinical staging of esophageal cancer (summary).
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Abstract

Cancer of the esophagus is a tumor with aggressive behavior that is usually diagnosed in advanced stages. The absence of serosa allows it to spread quickly to neighboring mediastinal structures, and an extensive lymphatic drainage network facilitates tumor spread even in early stages. The current TNM classification, harmonized with the classification for gastric cancer, provides new definitions for the anatomic classification, adds non-anatomic characteristics of the tumor, and includes tumors of the gastroesophageal junction. Combining endoscopic ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging provides greater accuracy in determining the initial clinical stage, and these imaging techniques play an essential role in the selection, planning, and evaluation of treatment. In this article, we review some particularities that explain the behavior of this tumor and we describe the current TNM staging system; furthermore, we discuss the different imaging tests available for its evaluation and include a diagnostic algorithm.

Keywords:
Esophagus
Esophagogastric junction
Esophageal neoplasms
Esophageal cancer
Esophagoscopy
Tomography, X-ray computed
Magnetic resonance imaging
Positron-emission tomography
Esophagectomy
Minimally invasive surgical procedures
Resumen

El cáncer de esófago es un tumor de comportamiento agresivo, que suele diagnosticarse en etapas avanzadas. La ausencia de serosa permite su rápida propagación a estructuras vecinas del mediastino, y una extensa red de drenaje linfático facilita la diseminación tumoral incluso en estadios precoces. La actual clasificación TNM, armonizada con la del cáncer gástrico, proporciona nuevas definiciones en la clasificación anatómica, añade características no anatómicas del tumor e incluye los tumores de la unión esofagogástrica. La mayor precisión en la determinación del estadio clínico inicial se obtiene con la combinación de ecoendoscopia, TC, PET-TC y RM, que desempeñan un papel esencial en la elección, la planificación y la evaluación del tratamiento. En este artículo repasamos algunas particularidades que explican el comportamiento de este tumor, revisamos la estadificación TNM actual y presentamos las distintas pruebas de imagen de que disponemos en la actualidad para su evaluación, incluyendo un algoritmo de diagnóstico.

Palabras clave:
Esófago
Unión esofagogástrica
Neoplasias esofágicas
Cáncer de esófago
Esofagoscopia
Tomografía computarizada
Resonancia magnética
PET
Esofagectomía
Cirugía mínimamente invasiva

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