Survival from cancer of the oesophagus in England and Wales up to 2001

Most patients with oesophageal cancer have locally advanced unresectable or metastatic disease before symptoms occur. They may present with difficulty in swallowing, indigestion, weight loss, anorexia or occasionally pain on swallowing. The mainstay of diagnosis is by endoscopy and biopsy. Computed tomography scans of the chest, abdomen and pelvis are usually performed to complete staging. In the last decade, endoscopic ultrasonography (EUS) has assumed a central role in the initial anatomic staging of oesophageal cancer because of its accuracy in assessing the extent of locoregional disease ( Vilgrain et al, 1990 ; Botet et al, 1991 ; Rosch et al, 1992 ). However, EUS was unlikely to have been widely used before 2001 and thus any impact on survival from better case selection will not be apparent in the data published by Mitry et al (2008) .