# Squamous cell carcinoma vs adenocarcinoma of the oesophagus

Source: https://onco.cc/terms/escc-vs-eac/  
OnCo record `escc-vs-eac` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Oesophageal cancer is two different diseases in one organ: squamous cell carcinoma (upper/mid oesophagus, tobacco and alcohol, dominant in Asia) and adenocarcinoma (lower oesophagus, reflux and obesity, dominant in the West).

## Summary

ESCC is ~85% of cases worldwide, concentrated in the 'oesophageal cancer belt' from Iran to China; genetically resembles head-and-neck squamous cancer (TP53, NOTCH1, CCND1, SOX2) and responds better to chemoradiation and immunotherapy. EAC arises from Barrett's, resembles gastric adenocarcinoma (HER2 amplification in ~15-20%), and is treated on gastric-like pathways (FLOT, trastuzumab, zolbetuximab trials). Trial eligibility, PD-L1 scoring (TAP vs CPS), and surgery differ between them.

## Fields

- Kind: Term
- Last checked: 2026-09-07

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Esophageal_cancer
- The Cancer Genome Atlas: integrated genomic characterization of oesophageal carcinoma (Nature 2017): https://doi.org/10.1038/nature20805

## Connected records

- cancers: [Oesophageal cancer](https://onco.cc/cancers/esophageal/)
- terms: [Barrett's oesophagus](https://onco.cc/terms/barretts-esophagus/), [Siewert classification (GEJ tumours)](https://onco.cc/terms/siewert-classification/)
- key papers: [Integrated genomic characterization of oesophageal carcinoma](https://onco.cc/key-papers/paper-cancer-genome-atlas-research-nature/)

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