Original articleGeneral thoracicEndoscopic Ultrasound: Accuracy in Staging Superficial Carcinomas of the Esophagus
Section snippets
Patients and Methods
From October 2002 to January 2007, 450 patients with carcinoma of the esophagus or gastroesophageal junction underwent EUS: 55 (5.8%) of them were staged as superficial carcinomas (T1m or T1sm) on EUS.
The endoscopic features of the tumor were assessed in all patients (ie, site and macroscopic appearance; Table 1), as were the ultrasound findings (including EUS staging), the histopathologic findings, and, for patients undergoing operation, the pathologic staging.
The staging accuracy of EUS, in
Results
Clinical and pathologic findings are summarized in Table 2. Our study population of 55 patients included 46 men (84%) and 9 women (16%), with a median age of 67 years (interquartile range, 59 to 72). The neoplasm was located in the upper thoracic esophagus in 3 patients (5%), in the mid thoracic esophagus in 17 patients (31%), and in the lower thoracic esophagus or gastroesophageal junction in 35 patients (64%).
The prevalent histologic type was adenocarcinoma in 33 patients (60%) [27 of these
Comment
To date, EUS is considered the best technique available to define locally advanced potentially curable lesions in patients with carcinoma of the esophagus and gastroesophageal junction. In the present study, its negative predictive value was 86% for T staging and 84% for N staging. Other studies have reported values close to 100%: Buskens and associates [7] found a negative predictive value of 95% for submucosal invasion and 93% for lymph node involvement, and Scotiniotis and coworkers [2]
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