Esophagus or food pipe is the structure that connects pahrynx (back of the mouth) to stomach, via thorax (chest). Thus it passes through 3 anatomical areas namely, neck, thorax and abdomen. This anatomy is the reason for complexity of the surgical procedure for this cancer.
Esophagus is approximately 25 cm long muscular tube. It can be arbitrarily divided into 4 parts; cervical, upper thoracic, mid thoracic and lower esophagus. Endoscopically this would correspond to 15 cm from incisor to 20 cm, 20 to 25 cm, 25 to 30 cm and 30 to gastroesophageal junction respectively.Tumors involving gastroesophageal junction and/or with their epicenter within 5 cm of the junction are treated akin to lower esophageal cancers.
Due to this unique anatomy, lymphatics from esophagus can drain into cervical, mediastinal or upper abdominal nodes.