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Endoscopic US and Dynamic CT in Preoperative TN Staging of Esophageal Squamous Cell Carcinoma
Author(s) -
FUJISHIMA Hiroshi,
CHIJIIWA Yoshiharu,
MARUOKA Akira,
MISAWA Tadashi,
NAWATA Hajime
Publication year - 1994
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1994.tb00370.x
Subject(s) - medicine , esophagectomy , radiology , endoscopic ultrasonography , lymph node , stage (stratigraphy) , carcinoma , esophageal squamous cell carcinoma , stenosis , esophagus , esophageal cancer , endoscopy , surgery , cancer , paleontology , biology
〈Objective〉 The aim of this study was to assess the accuracy and limitations of endoscopic ultrasonography (US) and dynamic computed tomography (CT) in the preoperative evaluation of esophageal carcinoma. 〈Methods〉 Endoscopic US and dynamic CT were performed preoperatively in 96 patients with an esophageal squamous cell carcinoma. The results were correlated with the histology of specimens resected from patients who had undergone subtotal esophagectomy with lymph node dissection. 〈Results〉 According to the TN staging classification, endoscopic US was superior to dynamic CT for evaluating the depth of tumor infiltration (overall accuracy: EUS 75%, CT 35%) and in assessing regional lymph node metastases (overall accuracy: EUS 77%, CT 67%). However, the T4 stage was not accurately evaluated using endoscopic US in this study. Its specificity was high (97%) but its sensitivity was low (45%). 〈Conclusions〉 We believe endoscopic US is the most accurate method for local tumor staging in esophageal carcinoma. A limitation to endoscopic US staging performed with current instruments was severe stenosis, as it would not permit passage of the instrument (25% of all cases in this study).