Endoscopic ultrasound for staging esophageal cancer, with or without dilation, is clinically important and safe

Kallimanis, George; Gupta, Pradeep Kumar; Al‐Kawas, Firas H.; Tio, Lok T.; Benjamin, Stanley B.; Bertagnolli, Maria E.; Nguyen, Cuong C.; Gomes, Mario N.; Fleischer, David E.

doi:10.1016/s0016-5107(95)70187-7

Cited by 86 publications

(24 citation statements)

References 20 publications

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“…Consequently, new echoendoscopic probes with bougie-shaped tips, small diameters and guidewire insertion have been developed [19, 37], with accuracy rates comparable to conventional echoendoscopes [19]. While tumor stenoses significantly decrease accuracy of conventional EUS [26, 35, 36], the clinical relevance of that association is minor since the advanced stages of stenosing tumors can rarely be treated by surgery alone [36, 38]. …”

Section: Discussionmentioning

confidence: 99%

Accuracy of Endoscopic Ultrasonography in Preoperative Staging of Esophageal Carcinoma

Heidemann¹,

Schilling²,

Schmassmann

et al. 2000

Dig Surg

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Background: With the advent of stage-adapted multimodal regimens for many gastrointestinal malignancies, accurate staging has become of utmost importance. In esophageal cancer, endoscopic ultrasonography (EUS) emerged as standard to determine T and N stage. Objective: Since growth patterns of squamous carcinoma (SC) differs from adenocarcinoma (AC) and lymph nodes are located at various distances from the esophagus in a horizontal plane, we studied the accuracy of esophageal EUS as a function of tumor type and localization of the tumor within the esophagus. Results: Overall staging accuracy was 79% for T and for N staging. Staging was more accurate for T3/4, when compared to T1/2 tumors, and for SC when compared to AC. Histological T1/2 stages were overstaged by EUS in 8/17 patients, mostly in patients with AC (6/10). The sensitivity of retrosternal pain and of dysphagia for extramural disease was 57 and 92% respectively, the specificity of pain for extramural disease was 73%, and of dysphagia 36%. Preoperative weight loss in this series correlated linearly with tumor stages. Conclusions: The accurate preoperative staging of T2 esophageal endodermal malignancies is crucial for treatment stratification but difficult to achieve by visual analysis of endosonography alone. Postacquisition processing of echoendosonographic images might further increase the accuracy of echoendosonography and aid in the critical differentiation of T2 versus T3 esophageal malignancies. Preoperative weight loss and retrosternal pain are good clinical indicators of extramural disease.

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Section: Discussionmentioning

confidence: 99%

Accuracy of Endoscopic Ultrasonography in Preoperative Staging of Esophageal Carcinoma

Heidemann¹,

Schilling²,

Schmassmann

et al. 2000

Dig Surg

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“…Early reports indicated high perforation rates with dilation of malignant strictures [7,27]. More recent experience [14,20,30], however, suggests perforation rates to be much lower, yet a risk remains. Although miniprobe sonography has been shown to be as accurate as standard echoendosonography [19], there are still concerns that miniprobes may not be adequate for regional staging of larger tumors or more distant nodes because of the limited ultrasonic penetration.…”

mentioning

confidence: 99%

The preferred choice for radial endosonographic staging of esophageal cancer: standard echoendoscope or nonoptic esophagoprobe?

Tsang

Doig

et al. 2007

Surg Endosc

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“…Dilation may be performed with either a Savary dilator over the wire, or with a through-the-scope (TTS) controlled radial expansion (CRE) dilation balloon. A higher rate of esophageal perforation has been reported with dilation of malignant esophageal strictures, but it is generally regarded as safe [11,12]. In our practice, if we experience resistance due to a malignant stricture precluding passage of a standard EGD scope or echoendoscope, we dilate with a TTS CRE balloon up to 14-16 mm so as to then allow for a complete and thorough staging EUS exam.…”

Section: Staging Of Esophageal Tumorsmentioning

confidence: 99%

EUS Staging of Luminal Cancers in the Upper GI Tract

Bucobo¹,

Buscaglia²

2011

New Techniques in Gastrointestinal Endoscopy

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Endoscopic ultrasound for staging esophageal cancer, with or without dilation, is clinically important and safe

Cited by 86 publications

References 20 publications

Accuracy of Endoscopic Ultrasonography in Preoperative Staging of Esophageal Carcinoma

Accuracy of Endoscopic Ultrasonography in Preoperative Staging of Esophageal Carcinoma

The preferred choice for radial endosonographic staging of esophageal cancer: standard echoendoscope or nonoptic esophagoprobe?

EUS Staging of Luminal Cancers in the Upper GI Tract

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