Oncology Procedure G9097: Esophageal Cancer (Adenocarcinoma or Squamous Cell Carcinoma)

Name of the Procedure:

• Common Names: Esophageal Cancer Evaluation
• Technical/Medical Term: Disease Status Assessment for Esophageal Cancer (T4, Any N, M0)

Summary:

This medical procedure involves assessing the disease status of esophageal cancer specifically limited to adenocarcinoma or squamous cell carcinoma. It evaluates the extent of the cancer prior to any neo-adjuvant therapy and confirms that there is no evidence of disease progression.

Purpose:

• Medical Conditions Addressed: Esophageal cancer, specifically adenocarcinoma or squamous cell carcinoma.
• Goals/Outcomes: The primary goal is to determine the initial extent of the disease (T4, any N, M0) and verify that there is no current evidence of disease progression before starting any neo-adjuvant therapy.

Indications:

• Symptoms/Conditions Warranting the Procedure: Diagnosed cases of esophageal cancer where adenocarcinoma or squamous cell carcinoma are the predominant cell types.
• Patient Criteria: Individuals with esophageal cancer at the staging T4 (invasion of structures like the aorta or trachea), any N (lymph node involvement),/M0 (no distant metastasis).

Preparation:

• Patient Instructions: Typically includes fasting for a certain period before imaging tests and adjusting medications as recommended by the healthcare provider.
• Diagnostic Tests: Pre-assessment diagnostic tests like CT scans, PET scans, endoscopic ultrasound (EUS), and biopsies may be performed.

Procedure Description:

1. Initial Consultation: Review of patient’s medical history and previous diagnostic tests.
2. Imaging: Advanced imaging techniques (CT, PET, or MRI scans) to assess the tumor's size and invasion (stage T4).
3. Endoscopy: An endoscope is used to visually examine the esophagus and acquire biopsies if necessary.
4. Assessment: Clinicians will analyze imaging and endoscopy results to confirm the stage and extent of the cancer.
   • Tools/Equipment: Endoscope, imaging machines (CT, PET, MRI).
   • Anesthesia/Sedation: Sedation may be used during endoscopic procedures.

Duration:

Typically varies between 1-2 hours, depending on the combination of imaging and endoscopic procedures performed.

Setting:

Performed in a hospital, outpatient clinic, or a specialized diagnostic center with endoscopy and imaging capabilities.

Personnel:

• Healthcare Professionals: Oncologists, gastroenterologists, radiologists, nurses, and anesthesiologists (if sedation is used).

Risks and Complications:

• Common Risks: Minor complications from sedation (e.g., drowsiness, nausea), temporary soreness post-endoscopy.
• Rare Risks: Injury to the esophagus, bleeding, or adverse reactions to contrast dye used in imaging tests.

Benefits:

• Expected Benefits: Accurate staging of esophageal cancer, guiding treatment planning (e.g., eligibility for neo-adjuvant therapy). Benefits typically realized promptly as treatment can be more accurately tailored to the cancer’s stage.

Recovery:

• Post-Procedure Care: Rest and monitoring post-sedation; follow dietary and medication instructions.

• Recovery Time: Typically short, with most patients resuming normal activities within 24 hours. Follow-up appointments for further treatment planning.

  Alternatives:

• Other Options: Additional or alternative imaging methods, surgical staging, or molecular testing.
• Pros and Cons: Alternative methods may offer different insights but may not be as comprehensive in staging (pros include less invasiveness; cons include potentially less detail in cancer staging).

Patient Experience:

• During the Procedure: Patients may experience mild discomfort from endoscopy; sedation typically minimizes discomfort.
• After the Procedure: Post-procedure soreness in the throat; sedation effects like drowsiness. Pain management with mild analgesics if necessary.

This markdown provides comprehensive information in a structured format, making it user-friendly and informative for both patients and healthcare professionals.