Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions

Douglas G. Adler, MD

Question 5: How Should Malignant Tracheoesophageal Fistulae Be Managed In Patients With Esophageal Cancer? (continued)

Ananya Das, MD, FACG, FASGE

A tracheoesophageal fistula develops in approximately 1% to 22% of all patients with esophageal cancer. These are usually caused by invasion into the respiratory tract by the malignant tumor arising from the esophagus. Although tracheal invasion is most common (50% to 60%), the fistulous communication often is with the bronchi (30% to 40%) or may be even with the peripheral lung parenchyma (3% to 10%), thus esophago-respiratory fistula (ERF) may be a more anatomically appropriate term. Generally, the fistulous communication is the end-result of a bulky aggressive tumor invading into the…