The Role of Endoscopic Ultrasonography in Staging of Esonphageal Cancer

Kim, Young Ho; Paik, Seung Woon; Rhee, Jong Chul; Kim, Jae Jun; Koh, Kwang Cheol; Lee, Hwa Young; Son, Hee Jung; Rhee, Poong Lyul; Sung, In Kyung

Abstract

BACKGROUND AND AIMS: Precise preoperative evaluation of esophageal cancer for complete resectability is very important to avoid unnecessary operation. However, staging modality such as CT cannot clearly define the depth of invasion and the presence of regional lymph node metastasis. Endoscopic ultrasonography (EUS) is considered as a useful method in evaluating loca1 staging and resectability of esophageal cancer. For 31 patients with esophageal cancer, we compared the accuracy of EUS with that of CT in the assessment of the depth of invasion and regional lymph node metastasis of esophageal cancer. The patients underwent surgery between August 1994 and October 1996.
METHODS
The EUS was performed using an echoendoscope GF-UM200 and water-filled balloon method. The delivered frequencies were 7.5 or 12 MHz. The classification of tumor staging by EUS and CT was based on the TNM system of UICC.
RESULTS
The overall accuracy of EUS (83%) was higher than that of CT (55%) in the assessment of depth of invasion. In T3 and T4, the accuracy of EUS was 100% each and that of CT was 81% and 75%, respectively. In T2, the accuracy of EUS was 25% due to overstaging. In detection of regional lymph node metastasis, the sensitivity of EUS (89%) was higher than that of CT (61%). For the detection of regional lymph node metastasis, the overall accuracy of EUS (84%) was higher than that of CT (71%). The accuracy of EUS for TN staging (80%) was higher than that of CT (43%).
CONCLUSIONS
The accuracy of EUS is higher than that of CT in staging of the tumor depth and regional lymph node metastasis ef esophageal cancer. Therefore, the EUS can be a useful method to evaluate the preoperative staging of esophageal cancer.