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Vol. 17, No. 3, 2000
Issue release date: 2000
Section title: Original Paper
Dig Surg 2000;17:219–224
(DOI:10.1159/000018838)

Accuracy of Endoscopic Ultrasonography in Preoperative Staging of Esophageal Carcinoma

Heidemann J. · Schilling M.K. · Schmassmann A. · Maurer C.A. · Büchler M.W.
Departments of aVisceral and Transplantation Surgery and bGastroenterology, Inselspital Bern, University of Bern, Switzerland

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 6/22/2000

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU

Abstract

Background: With the advent of stage-adapted multimodal regimens for many gastrointestinal malignancies, accurate staging has become of utmost importance. In esophageal cancer, endoscopic ultrasonography (EUS) emerged as standard to determine T and N stage. Objective: Since growth patterns of squamous carcinoma (SC) differs from adenocarcinoma (AC) and lymph nodes are located at various distances from the esophagus in a horizontal plane, we studied the accuracy of esophageal EUS as a function of tumor type and localization of the tumor within the esophagus. Results: Overall staging accuracy was 79% for T and for N staging. Staging was more accurate for T3/4, when compared to T1/2 tumors, and for SC when compared to AC. Histological T1/2 stages were overstaged by EUS in 8/17 patients, mostly in patients with AC (6/10). The sensitivity of retrosternal pain and of dysphagia for extramural disease was 57 and 92% respectively, the specificity of pain for extramural disease was 73%, and of dysphagia 36%. Preoperative weight loss in this series correlated linearly with tumor stages. Conclusions: The accurate preoperative staging of T2 esophageal endodermal malignancies is crucial for treatment stratification but difficult to achieve by visual analysis of endosonography alone. Postacquisition processing of echoendosonographic images might further increase the accuracy of echoendosonography and aid in the critical differentiation of T2 versus T3 esophageal malignancies. Preoperative weight loss and retrosternal pain are good clinical indicators of extramural disease.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 6/22/2000

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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