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Squamous cell carcinoma of the oesophagus, the world's commonest form, is linked to smoking, alcohol and very hot drinks and sits in the upper and middle gullet. It is treated with chemoradiation, with or without surgery, and immunotherapy has recently joined chemotherapy for advanced disease.
Oesophageal squamous cell carcinoma arises from the squamous lining of the upper and middle oesophagus; tobacco, alcohol, scalding drinks, nutritional deficiency and achalasia are its causes, and TP53 and NOTCH1 mutations its genetics. Early lesions found by endoscopy, common in Japanese and Chinese screening programmes, are removed endoscopically. Locally advanced disease is treated either with neoadjuvant chemoradiation followed by surgery (CROSS) or with definitive chemoradiation alone, which cures a similar share in this histology; adjuvant nivolumab after chemoradiation and surgery lowers recurrence when residual disease remains (CheckMate 577). Advanced disease is treated with nivolumab plus chemotherapy or nivolumab plus ipilimumab (CheckMate 648) or pembrolizumab plus chemotherapy (KEYNOTE-590); Chinese trials with camrelizumab, tislelizumab, toripalimab and sintilimab have produced the same result.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
Squamous cancers sit in the upper and middle oesophagus, adenocarcinomas at the junction and in the stomach; the stomach wall also gives rise to GIST from its pacemaker cells.
Same organ: Gastric & gastro-oesophageal junction cancer, HER2-positive gastric cancer, Claudin 18.2-positive gastric cancer, PD-L1-high gastric cancer, Microsatellite-unstable (MSI-high) gastric cancer, Early gastric cancer, Oesophageal and junctional adenocarcinoma, Oesophageal cancer, Gastrointestinal stromal tumour (GIST), KIT exon 11-mutant GIST, PDGFRA D842V-mutant GIST, Imatinib-resistant GIST
Endoscopic submucosal dissection; oesophagectomy or chemoradiation if deeper invasion is found.
Neoadjuvant carboplatin-paclitaxel chemoradiation and surgery (CROSS), or definitive cisplatin-fluorouracil chemoradiation with surgery reserved for persistent disease; adjuvant nivolumab after incomplete response (CheckMate 577).
Nivolumab plus chemotherapy or nivolumab plus ipilimumab (CheckMate 648), or pembrolizumab plus chemotherapy (KEYNOTE-590).
Smoking cessation, alcohol reduction, avoiding very hot drinks; endoscopic screening in high-incidence regions of China.
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Nivolumab plus chemotherapy or nivolumab plus ipilimumab are first-line standards for advanced oesophageal squamous cell carcinoma, joining pembrolizumab-chemotherapy from KEYNOTE-590.
Adjuvant nivolumab is standard for patients with residual disease after trimodality therapy for oesophageal cancer.
Pembrolizumab plus chemotherapy is a first-line standard for advanced oesophageal cancer, with the strongest recommendation for PD-L1-expressing tumours.
CROSS chemoradiotherapy is a standard for locally advanced oesophageal cancer, particularly squamous cell carcinoma; for adenocarcinoma, perioperative FLOT is now often preferred after ESOPEC.
Query for this cancer: (TITLE:"Oesophageal squamous cell carcinoma" OR ABSTRACT:"Oesophageal squamous cell carcinoma" OR TITLE:"Esophageal squamous cell carcinoma" OR ABSTRACT:"Esophageal squamous cell carcinoma" OR TITLE:"ESCC" OR ABSTRACT:"ESCC" OR TITLE:"Oesophageal SCC" OR ABSTRACT:"Oesophageal SCC") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Oesophageal squamous cell carcinoma, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Bleeding that does not stop by itself, bleeding from more than one site, or new bruising in several places or one large area.
Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
Capecitabine: take within 30 minutes after a meal. DPD deficiency (DPYD variants) causes severe toxicity: pre-treatment genotyping is recommended in Europe.
No pharmacokinetic interactions expected (antibody). See the irAE guide for toxicity management.
Dose by Calvert formula using GFR (see the calculators).
Dose reduce or avoid for CrCl below 60 (carboplatin is the alternative).
See all on the product pages:CarboplatinCisplatinFluorouracil (5-FU)IpilimumabNivolumabPaclitaxel / nab-paclitaxelPembrolizumab·Printable cards in the navigator
Newly diagnosed? Read the first 60 days with Oesophageal squamous cell carcinoma, then print the one-page appointment sheet with room for the answers.
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Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record.
Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked.