Oesophageal Cancer Aaron Hui

Introduction 2 Main types (squamous and adenocarcinoma) Incidence of adenocarcinoma is rising 3-4 / 100000 Western society Poor Prognosis

Pathophysiology Chronic Mucosal irritation Genetic factors Environmental factors

Squamous Cell Adenocarcinoma Demographic and socioeconomic factors Gastroesophageal reflux disease Smoking and alcohol Smoking Dietary factors Alcohol Underlying oesophageal disease  Obesity Human papilloma virus Helicobacter pylori infection  Bisphosphonates  Increased oesophageal acid exposure  Use of drugs that decrease lower oesophageal sphincter pressure

Barrett’s Eosophagus

Clinical presentation -Dysphagia -Weight loss -Routine screening for Barrett’s -Hoarseness Distant metastasis Paraneoplastic syndrome

Diagnosis Barium Studies Gastroscopy CT, PET EUS

Surgical Treatment

Gastric Cancer Aaron Hui

Introduction Majority adenocarcinoma 50% of people have locally advanced disease at time of presentation 2 main types A proven infectious agent

Pathophysiology Intestinal-type (well-differentiated) Pre neoplastic cascade: 1. Non atrophic gastritis  2. Atrophic gastritis  3. Intestinal Metaplasia  4. Dysplasia  5. Invasive Carcinoma Diffuse type (poorly differentiated) - E-cadherin

Diagnosis Barium studies Gastroscopy High resolution Helical Abdo CT

Surgical Treatment