Original ArticlesImpact of EUS-guided fine-needle aspiration on lymph node staging in patients with esophageal carcinoma☆,☆☆
Section snippets
Patients
Search of the endoscopy database was performed to identify all patients evaluated for esophageal carcinoma from May 1996 through May 1999. Retrospective chart review was then undertaken to identify patients with esophageal carcinoma and the following criteria: (1) free of distant metastases based on CT (patients with celiac lymph node metastases by CT without biopsy confirmation before EUS were not excluded), (2) overall medical status permitting operative therapy, (3) no prior chemotherapy or
Results
Accuracy of EUS for T stage was 84% (95% CI [70%, 93%]) (Table 2). Overall accuracy for EUS was 84% (95% CI [70%, 93%]).Pathology Empty Cell pT1 pT2 pT3 pT4 EUS T1 1 0 1 0 T2 0 8 0 0 T3 1 2 22 0 T4 0 0 2 0
Discussion
EUS-FNA of nonperitumoral lymph nodes in patients with esophageal carcinoma provided an accuracy of 93% (95% CI [79%, 98%]) in overall lymph node assessment (regional and celiac lymph nodes combined). Before routine initiation of EUS-FNA, the overall lymph node staging accuracy with EUS alone was lower, 70% (95% CI [53%, 98%]) (p = 0.02). This performance advantage occurred in a patient population evaluated with EUS by endosonographers who each had previous experiences with more than 60
References (33)
- et al.
Multimodality therapy for esophageal cancer
Chest
(1997) - et al.
Superiority of extended en bloc esophagogastrectomy for carcinoma of the lower esophagus and cardia
J Thorac Cardiovasc Surg
(1993) - et al.
Selective therapeutic approach to cancer of the lower esophagus and cardia
J Thorac Cardiovasc Surg
(1988) - et al.
Local staging and assessment of resectability in carcinoma of the esophagus, stomach and duodenum by endoscopic ultrasonography
Gastrointest Endosc
(1992) - et al.
Staging of esophageal cancer: computed tomography, magnetic resonance imaging and endoscopic ultrasound
Semin Roentgenol
(1994) - et al.
Observer variation and reproducibility of endoscopic ultrasonography
Gastrointest Endosc
(1995) - et al.
Endosonographic T-staging of esophageal carcinoma: a learning curve
Gastrointest Endosc
(1996) - et al.
Evaluation of metastatic celiac lymph nodes in patients with esophageal carcinoma: accuracy of EUS
Gastrointest Endosc
(1999) - et al.
Dilation of malignant esophageal stenosis to allow EUS guided fine-needle aspiration: safety and effect on patient management
Gastrointest Endosc
(2000) - et al.
Endoscopic ultrasonography in esophageal diseases
Gastrointest Endosc
(1989)
Endosonographic features predictive of lymph node metastasis
Gastrointest Endosc
Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment
Gastroenterology
EUS-guided, fine-needle aspiration biopsy using a new mechanical scanning puncture echoendoscope
Gastrointest Endosc
Surgery of squamous cell carcinoma of the esophagus
Ann Oncol
Ratio of invaded to removed lymph nodes as a predictor of survival in squamous cell carcinoma of the esophagus
Br J Surg
A comparison of multimodal therapy and surgery for esophageal adenocarcinoma
N Engl J Med
Cited by (189)
Impact of EUS in liver transplantation workup for patients with unresectable perihilar cholangiocarcinoma
2024, Gastrointestinal EndoscopyAdvances in Diagnostic, Staging, and Restaging Evaluation of Esophageal and Gastric Cancer
2024, Surgical Oncology Clinics of North America18F-FDG-PET/CT Imaging for Gastrointestinal Malignancies
2021, Radiologic Clinics of North AmericaEndoscopic Evaluation of the Esophagus and Endoscopic Ultrasonography of the Esophagus
2019, Shackelford's Surgery of the Alimentary Tract: 2 Volume SetEndoscopic Ultrasonography in the Evaluation of Posterior Mediastinal Lesions
2018, Endosonography, Fourth Edition
- ☆
Reprint requests: Maurits J. Wiersema, MD, 200 First St. SW, Mayo Clinic, Eisenberg 8A, Rochester, MN 55905.
- ☆☆
Gastrointest Endosc 2001;53:751-7