Can miniprobe endoscopic ultrasound accurately stage esophageal cancer and guide therapeutic decisions in the era of neoadjuvant therapy?

Author(s):  
T Meister ◽  
HS Heinzow ◽  
H Seifert ◽  
T Wehrmann ◽  
T Kucharztik ◽  
...  
2012 ◽  
Vol 93 (6) ◽  
pp. 1855-1860 ◽  
Author(s):  
Jeffrey M. Griffin ◽  
Carolyn E. Reed ◽  
Chadrick E. Denlinger

2010 ◽  
Vol 76 (11) ◽  
pp. 1228-1231 ◽  
Author(s):  
Brian R. Smith ◽  
Kenneth J. Chang ◽  
John G. Lee ◽  
Ninh T. Nguyen

Endoscopic ultrasonography (EUS) is a common staging modality used in patients with esophageal cancer. The objective of this analysis was to evaluate the accuracy and sensitivity of EUS in determining the depth of penetration (T stage) and nodal status (N stage) in patients with esophageal cancer who underwent minimally invasive esophagectomy (MIE). A retrospective analysis of all patients at a university hospital who underwent preoperative EUS followed by MIE for cancer was performed. We compared the results of preoperative EUS to final pathologic analyses of the esophageal specimen, examining the accuracy of EUS staging. Ninety-five patients with esophageal cancer who underwent MIE had preoperative EUS. Twenty-four of the 95 patients were excluded for lack of a repeat EUS after neoadjuvant therapy before resection. Hence, 71 patients were evaluated for the accuracy of EUS staging. The accuracy of EUS for TO disease was 80 per cent; T1 disease was 75 per cent; T2 disease was 39 per cent; and T3 disease was 88 per cent. The overall EUS accuracy for T stage was 72 per cent with overstaging occurring mostly for pathologic T1 tumors in 18 per cent and understaging occurring mostly for pathologic T3 tumors in 11 per cent. The sensitivity and specificity for detection of nodal involvement were 79 per cent and 74 per cent, respectively. However the accuracy for T and N staging by EUS after neoadjuvant therapy decreased to 63 per cent and 38 per cent, respectively. Endoscopic ultrasound in the absence of neoadjuvant therapy is a relatively accurate and sensitive modality for determining the depth of tumor penetration and the presence of nodal disease in patients with esophageal carcinoma. The accuracy for T and N staging is less reliable after neoadjuvant therapy.


2017 ◽  
Vol 62 (6) ◽  
pp. 1647-1656 ◽  
Author(s):  
Zachary L. Smith ◽  
Jason E. Gonzaga ◽  
George B. Haasler ◽  
Elizabeth M. Gore ◽  
Kulwinder S. Dua

2008 ◽  
Vol 6 (9) ◽  
pp. 862-869 ◽  
Author(s):  
Kwang-Yu Chang ◽  
Jang-Yang Chang ◽  
Joseph Chao ◽  
Yun Yen

Esophageal cancer is the eighth most common cancer worldwide, and one of the most fatal diseases despite modern medical treatment. Because correct staging and surveillance of neoadjuvant therapy for esophageal cancer is mandatory for further treatment planning, choosing a modern imaging system is important. The development of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) has provided alternate means of tumor detection distinct from more conventional methods. This modality has extraordinary performance in detecting locoregional lymph node involvement and distant metastatic disease, and has been introduced as a powerful tool in many guidelines. However, some factors still lead to false-negative or -positive results, raising questions of its accuracy. This article discusses the clinical efficacy of PET in staging and surveillance of neoadjuvant therapy in esophageal cancer, comparing its accuracy with conventional imaging modalities.


2011 ◽  
Vol 25 (2) ◽  
pp. 137-145 ◽  
Author(s):  
S. Aiko ◽  
I. Kumano ◽  
N. Yamanaka ◽  
H. Tsujimoto ◽  
R. Takahata ◽  
...  

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