ORIGINAL ARTICLES   

Minerva Chirurgica 1999 April;54(4):205-12

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

The role of endosonography in the staging of esophageal squamous cell carcinoma. Correlation between surgical and anatomopathological findings

Massari M., Pavoni G. M., Cioffi U., De Simone M., Lattuada E., Celotti S., Faini G., Brocchi A., Pietri P.

Background. Endoscopic ultrasonography (EUS) is a relatively new diagnostic method to assess the extent and the depth of infiltration of esophageal carcinoma.
Methods. From October 1990, 100 patients affected by esophageal squamous cell carcinoma underwent preoperative evaluation with endoscopic ultrasonography, 85 of whom were operated on. The first 23 patients underwent endosonography with an Olympus GF-EUM2 with a 7.5 MHz echoprobe; the remaining 77 patients underwent EUS with an Olympus GF-EUM3 with a 7.5-12 MHz echoprobe.
Results. In 33 cases (33%), the procedure was not completed because of the impossibility of passing through the neoplastic stenosis. The depth of infiltration was correctly defined by EUS in 73 of 85 patients (86%) compared with 47% of Computed Tomography (CT) (p<0.05). Overestimation occurred in 6 patients (7%), whereas underestimation occurred in 6 cases (7%). Lymphnode involvement was correctly classified by EUS in 50 of 57 patients (88%) compared with 39% of CT.
Conclusions. EUS provides a high degree of accuracy in assessing both T and N parameters in staging esophageal cancer. The major problem of the method is still the frequent impossibility of passing through a neoplastic stenosis.