Cancer de l'œsophage cervical: Diagnostic, indications thérapeutiques

Three to 10 % of oesophageal carcinomas arise from the cervical portion. Not only the anatomy but the treatment and the prognosis of these tumours are intermediate between hypopharyngeal and oesophageal tumours. The proximity of the larynx raises the problem of voice preservation. The main curative options are surgery and radiotherapy and their respective indications are still debated. Surgery seems to allow a better locoregional control but usually includes a total laryngectomy. Whatever the treatment, the overall prognosis remains poor. Evaluation of new chemotherapy regimens, modification of fractionation of radiotherapy and concomitant chemo radiation is still in progress. Endoscopic treatment of limited tumours and palliative treatment for dysphagia, such as stenting or laser debulking, have been less developed for cervical portion of the oesophagus than for other oesophageal locations primarily due to the proximity of the larynx adding further difficulties to these techniques.