scholarly journals Esophageal cancer N staging study with endoscopic ultrasonography

2018 ◽  
Author(s):  
Yueming Zhang ◽  
Shun He ◽  
Lizhou Dou ◽  
Yong Liu ◽  
Yan Ke ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Endoscopic Ultrasonography ◽  
N Staging

scholarly journals Comparison Between Size and Stage of Preoperative Tumor Defined by Preoperative Magnetic Resonance Imaging and Postoperative Specimens After Radical Resection of Esophageal Cancer

2019 ◽  
Vol 18 ◽  
pp. 153303381987626
Author(s):  
Zhenzhen Gao ◽  
Beibei Hua ◽  
Xiaolin Ge ◽  
Jinyuan Liu ◽  
Lei Xue ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Esophageal Cancer ◽  
Magnetic Resonance ◽  
Esophageal Tumor ◽  
Preoperative Treatment ◽  
Pathological Stage ◽  
Resonance Imaging ◽  
Surgical Specimen ◽  
Tumor Length ◽  
N Staging

Background: Our objective is to explore the accuracy of magnetic resonance imaging in determining the preoperative T and N staging, pathological stage, and the length of esophageal tumor in patients with esophageal cancer. Methods: This retrospective analysis included 57 patients admitted to the Department of Thoracic Surgery of The First Affiliated Hospital of Nanjing Medical University between January 2015 and December 2016. Postoperative pathological results were used as the reference to verify the accuracy of magnetic resonance imaging in evaluating tumor T and N staging, pathological stage, and tumor length. The correlation between tumor lengths—measured using magnetic resonance imaging and the surgical specimen measurements—was evaluated. Results: The mean age of the patients was 64.6 ± 7.2 years, with a range of 47 to 77 years. The overall accuracy rate of magnetic resonance imaging in T staging of esophageal cancer was 63.2%; magnetic resonance imaging was generally consistent in the N staging of esophageal cancer. Magnetic resonance imaging and surgical evaluation of tumor length were in excellent agreement (κ = .82, P < .001), while that of gastroscopy and postoperative pathology was moderate (κ = .63, P < .001). Conclusion: Magnetic resonance imaging is highly accurate in determining the preoperative T and N staging, pathologic stage, and tumor length in patients with esophageal cancer, which is important in deciding the choice of preoperative treatment and the surgical approach.

Comparison of clinical and pathologic staging in esophageal cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 31-31
Author(s):  
Anthony Joseph Scholer ◽  
Abhineet Uppal ◽  
Debopriya Ghosh ◽  
Mary Kledzik ◽  
Juan Santamaria-Barria ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Disease Free Survival ◽  
Clinical Staging ◽  
Tumor Characteristics ◽  
Kappa Index ◽  
Early Esophageal Cancer ◽  
Cross Sectional ◽  
Pathologic Staging ◽  
Endoscopy Ultrasound ◽  
N Staging

31 Background: Randomized trials have demonstrated improved disease-free survival for more advanced esophageal cancer treated with neoadjuvant chemo radiation (NCXRT). However, accurately treating a patient relies on the accuracy of pre-treatment T and N staging with endoscopy ultrasound and cross-sectional imaging, which is unknown, and can lead to over or under-treatment. Therefore, the objective of this study is to compare the clinical and pathologic staging in patients with early esophageal cancer that would be impacted by inaccurate clinical staging. Methods: Primary, non-metastatic esophageal cancer patients who had upfront esophagectomy without neoadjuvant CXRT between 2004 and 2013 were identified in the National Cancer database. The Kappa index was used to determine patient and tumor characteristics that effected concordance between clinical and pathologic T and N staging (p > 0.05 shows discordance). Results: Of 1810, 43 % of clinical T2 tumors were upstaged compared to 38% of T1 and 13% of clinical T2 were downstaged. Clinically positive N1 disease had the greatest concordance (91%) between clinical and pathologically staging, compared to clinical N0, where 57% were upstaged. Some patient groups significantly impacted the concordance rates of staging. T-Stage was less accurate (more discordant) in females (68%, kappa 0.41, p = 0.057) and Blacks (59%, kappa 0.023, p = 0.069) whereas overall N-stage was more discordant in Hispanics (83%, kappa, 0.67, p = 0.165). Conclusions: Accurate staging for esophageal adenocarcinoma can significantly impact the course of treatment. Upfront surgical resection of clinical T1 lesions and node negative tumors are at risk for under-treatment due to poor concordance with pathological stage, which may lead to decreased survival compared to a regimen of NCXRT. Clinicians should be aware of patient and tumor characteristics that increase the likelihood of discordance between clinical and pathologic staging when discussing treatment options for patients with esophageal cancer.

Endoscopic Ultrasonography for Assessment of the Response to Combined Radiation Therapy and Chemotherapy in Patients with Esophageal Cancer

Endoscopy ◽  
1997 ◽  
Vol 29 (01) ◽  
pp. 4-9 ◽  
Author(s):  
M. Giovannini ◽  
J. F. Seitz ◽  
P. Thomas ◽  
J. M. Hannoun-Levy ◽  
H. Perrier ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Endoscopic Ultrasonography
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