Our Experiences in Preoperative Assesment of Esophageal Carcinoma with Endoscopic Ultrasound and Computed Tomography

Introduction:

Patients with advanced esophageal carcinoma have still poor prognosis independent of form of therapy. 5-year survival for patients with N1 stage is just 5–15% compared with those with N0 stage 40–60%. Patients with T4 stage have poor prognosis regardles of further therapy. Endoscopic ultrasonography is an excellent diagnostic tool in staging carcinoma for selecting proper therapeutical approach.

Aim of the Study:

To compare EUS and CT assesment with surgical and histopathologic findings using TNM classification.

Materials and Methods:

In a 3.5 years period (January 2002– june 2005) in 28 patients with oesophageal cancer, EUS and CT was performed.

Results:

Among our patients, 12 (42.9%) have been treated surgically and 3 (10.7%) with radiotherapy or neoadjuvant therapy, one patient (3.6%) refused surgical treatment. Due to advanced disease or other comorbid conditions 12 (42.9%) patients could not be treated operatively. In 4 patients (14.3%) we underestimated T-stage. For 6 patients (21.5%) surgical treatment was successful and radical, but for 6 (21.5%) of them just palliative therapy was possible. In 10 patients (35.7%) oesophagus could not be traversed due to malignant stenoses. Accuracy of EUS and CT for T-staging was 67%, for N-staging 67% for EUS.

Conclusions:

Like in our patients, a number of study have shown better accuracy of EUS for T-staging compared with CT or other imaging methods for oesophageal cancer. We had a lower assesment of tumors, especially due to smal number of patients and relative higher number of them with nontraversable esophagus. This is a problem of diagnostic procedures performed in advanced stages of disease.