This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Diagnostic Evaluation of the Esophagus, Subject name: Surgery
All the following statement regarding this radiological film representing esophagus is true except? 
Select and explain. 
A. Squamous cell usually affects the upper two-thirds, B. Adenocarcinoma usually affects the lower-third, C. Lymph node involvement is a bad prognostic factor, D. Dysphagia is the most common and early presenting symptom
D: Dysphagia is the most common and early presenting symptom
Answer: D: Dysphagia is the most common and early presenting symptom 
Explanation: Ans. (d) Dysphagia is the most common and early presenting symptom.Carcinoma of the esophagus* Squamous cell usually affects the upper two-thirds; adenocarcinoma usually affects the lower-third* Common etiological factors are tobacco and alcohol (squamous cell) and GORD (adenocarcinoma)* The incidence of adenocarcinoma is increasing* Lymph node involvement is a bad prognostic factor* Dysphagia is the most common presenting symptom, but is a late feature* Accurate pretreatment staging is essential in patients thought to be fit to undergo 'curative' treatmentImage source- style="font-family: Times New Roman, Times, serif">