Endoscopic ultrasound: impact on survival in patients with esophageal cancer

Schrager, Jason; Tarpley, John L.; Smalley, Walter E.; Austin, Mary T.; Pearson, A. Scott

doi:10.1016/j.amjsurg.2005.07.002

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…With an accuracy of around 86% (60–90%), EUS has become the most widely accepted modality in evaluating the T‐stage of esophageal cancer . EUS accuracy increases with depth of invasion and has less overall accuracy for T1 lesions .…”

Section: Discussionmentioning

confidence: 99%

“…Patients with T1 (invasion up to but not beyond the submucosa) and T2 (up to the muscularis propria) lesions typically undergo up front endoscopic or surgical resection while those with deeper invasion (≥T3, up to or beyond the adventitia) usually receive neoadjuvant chemoradiation therapy followed by surgical resection if appropriate. EUS provides good loco‐regional staging information . However, EUS requires expertise, is not universally available, and can be associated with adverse events …”

Section: Introductionmentioning

confidence: 99%

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Utility of dysphagia grade in predicting endoscopic ultrasound T-stage of non-metastatic esophageal cancer

Fang

Szabó

et al. 2015

Dis Esophagus

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Patients with non-metastatic esophageal cancer routinely undergo endoscopic ultrasound (EUS) for loco-regional staging. Neoadjuvant therapy is recommended for ≥T3 tumors while upfront surgery can be considered for ≤T2 lesions. The aim of this study was to determine if the degree of dysphagia can predict the EUS T-stage of esophageal cancer. One hundred eleven consecutive patients with non-metastatic esophageal cancer were retrospectively reviewed from a database. Prior to EUS, patients' dysphagia grade was recorded. Correlation between dysphagia grade and EUS T-stage, especially in reference to predicting ≥T3 stage, was determined. The correlation of dysphagia grade with EUS T-stage (Kendall's tau coefficient) was 0.49 (P < 0.001) for the lower and 0.59 (P = 0.008) for the middle esophagus. The sensitivity and specificity of dysphagia grade ≥2 (can only swallow semi-solids/liquids) for T3 cancer were 56% (95% confidence interval [CI] 43-67%) and 93% (95% CI 79-98%), respectively. The sensitivity, specificity, and positive predictive value of dysphagia grade ≥3 (can only swallow liquids or total dysphagia) for T3 lesions were 36% (95% CI 25-48%), 100% (95% CI 89-100%), and 100% (95% CI 83-100%), respectively. Overall, there was a significant positive correlation between dysphagia grade and the EUS T-stage of esophageal cancer. All patients with dysphagia grade ≥3 had T3 lesions. This may have clinical implications for patients who can only swallow liquids or have complete dysphagia by allowing for prompt initiation of neoadjuvant therapy, especially in countries/centers where EUS service is difficult to access in a timely manner or not available.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Utility of dysphagia grade in predicting endoscopic ultrasound T-stage of non-metastatic esophageal cancer

Fang

Szabó

et al. 2015

Dis Esophagus

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“…The mere introduction of an EUS-based pretherapeutic imaging strategy was found to improve the overall survival of esophageal cancer patients compared with a CT-based imaging strategy [22,23]. Others have failed to verify this [24], and the poor outcome in cases of advanced disease, regardless of treatment, may be an important factor in the discussion [17,25]. The patients in this study were treated based on the findings of EUS-LUS, and although no adjuvant/neoadjuvant therapy had been provided, the survival data after R0 resection were comparable with the data in the literature (Table 2).…”

Section: Impact Of Eus-lus On Survivalmentioning

confidence: 95%

Combined pretherapeutic endoscopic and laparoscopic ultrasonography may predict survival of patients with upper gastrointestinal tract cancer

et al. 2010

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“…A transthoracic three-field lymphadenectomy carries considerable morbidity and since node positive disease has such a poor prognosis, considerable efforts are now made to exclude local extension and node involvement with endoluminal ultrasound [17,18] and more distant disease with a CT-PET scan [19]. The transhiatal operation has much the same long-term outcome and since this approach carries less morbidity than the transthoracic operation this may have some advantage [20].…”

Section: Esophageal Carcinoma In 1985 Was the Ninth Most Common Maligmentioning

confidence: 99%

The Changing Management of Esophageal Carcinoma: Survival in a Population Cohort 1985-1994

Bates¹,

Antoniou²,

Marshall³

et al. 2008

TOCCJ

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Abstract:Background: The management of esophageal carcinoma is changing but before the introduction of chemotherapy and multidisciplinary teams, surgery became more selective. The aim of this study was to confirm this trend and to examine survival in a total population cohort 1985-94.Results: Only a quarter of 413 patients had surgery but from 1989 even fewer were operated on but there were more longterm survivors: 1/51 v. 7/58 (p<0.05). Operative mortality fell from 12% to 6.9 % in the later period (N.S.) and survival post surgery was marginally improved, 15 v. 11 months p = 0.0502. The five year survival rate doubled from 7.8% to 17.2%. Conclusion:Few studies of esophageal cancer include all cases in a defined population. This carries a very poor prognosis but the present cohort shows a slight improvement with more selective surgery and this may serve as a benchmark against which modern multidisciplinary management might be compared.

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Endoscopic ultrasound: impact on survival in patients with esophageal cancer

Cited by 8 publications

References 16 publications

Utility of dysphagia grade in predicting endoscopic ultrasound T-stage of non-metastatic esophageal cancer

Utility of dysphagia grade in predicting endoscopic ultrasound T-stage of non-metastatic esophageal cancer

Combined pretherapeutic endoscopic and laparoscopic ultrasonography may predict survival of patients with upper gastrointestinal tract cancer

The Changing Management of Esophageal Carcinoma: Survival in a Population Cohort 1985-1994

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