Endosonography can detect residual tumour infiltration after medical treatment of oesophageal cancer in the absence of endoscopic lesions.

Abstract

Endoscopic ultrasound (endosonography) is useful in the preoperative staging of oesophageal tumours. It may also have a role in evaluation and surveillance of patients with inoperable carcinomas. Thirty four patients with inoperable oesophageal cancer were investigated by endosonography and computed tomography before medical treatment. In 10 patients receiving combined chemotherapy and radiotherapy, the endoscopic lesions resolved and biopsy specimens were negative. When endosonography suggested the persistence of tumour infiltration in these patients, a local recurrence or distant metastases appeared within a few months. In contrast, when no infiltration was detected, no tumoral recurrence or progression was observed within eight months. These results suggest that endosonography is better than endoscopic biopsy specimens and computed tomography in assessing the response of oesophageal carcinoma to non-surgical treatment. (Gut 1992; 33: 1459-1461 Assessing the response to chemotherapy in oesophageal carcinoma is not easy and is based on data provided by endoscopy, histopathology, and computed tomography. This study aimed to assess the usefulness of endosonography in the surveillance of these patients.

Factors Predictive of Tumor Recurrence and Survival After Initial Complete Response of Esophageal Squamous Cell Carcinoma to Definitive Chemoradiotherapy

“…Intensive follow-up of high-risk patients would contribute to the earlier detection of recurrence and thus improved survival after recurrence. The utility of endosonography compared with CT or endoscopy in the assessment of residual cancer after CRT has been reported (18,19). Endosonography can detect small lymph nodes or small submucosal lesions that are undetectable by CT or endoscopy.…”

Response evaluation with endoscopic ultrasound and computed tomography in esophageal squamous cell carcinoma treated by definitive chemoradiotherapy

“…EUS can identify residual submucosal tumors in the absence of superficial lesions. In addition, tumor size change or post‐CRT tumor size measured by EUS correlates with pathological response and predicts local recurrence after esophagectomy . CT scan is less accurate than EUS in assessing primary tumor response, but it offers an overview from neck to abdomen to assess size change in metastatic lesions .…”

“…Previous studies had focused on analyzing the accuracy of these image modalities in predicting pathological response for patients treated by neoadjuvant CRT plus surgery. However, in patients treated by CRT alone, there is no way to know their pathological response, and little is known about how to evaluate their treatment response and the impact of response on prognosis . Therefore, in this study, we evaluated the feasibility of combined EUS and CT scan for treatment response evaluation of ESCC treated by CRT alone.…”

“…In addition, tumor size change or post-CRT tumor size measured by EUS correlates with pathological response and predicts local recurrence after esophagectomy. [10][11][12][13] CT scan is less accurate than EUS in assessing primary tumor response, but it offers an overview from neck to abdomen to assess size change in metastatic lesions. 14,15 Previous studies had focused on analyzing the accuracy of these image modalities in predicting pathological response for patients treated by neoadjuvant CRT plus surgery.…”

Endoscopic Ultrasound Staging of Esophageal Cancer: Assuming Responsibility

“…Patients with submucosal extrinsic tumors that are not accessible to mucosal biopsies can be diagnosed with EUS-guided biopsies (17)(18)(19)(20).…”