Staging and prognosis using endosonography in patients with inoperable esophageal carcinoma treated with combined intraluminal and external irradiation

Tio, Lok T.; Blank, L.E.C.M.; Wijers, Oda B.; Jager, F.C.A. den Hartog; Dijk, J.D.P. van; Tytgat, G. N. J.

doi:10.1016/s0016-5107(94)70061-3

Cited by 26 publications

(8 citation statements)

References 26 publications

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“…In contrast to the accuracy of EUS determination of T and N stages prior to surgical treatment without CRT, previous studies have found poor correlation between standard EUS after CRT T-staging and pathologic findings [23,24,25,26,27,28,29]. Nevertheless, numerous authors have attempted to demonstrate the prognostic role of EUS in esophageal cancer treated with CRT by measuring the radial tumor thickness [30], total disease length [31], tumor volume [32], or tumor area [16,29,33,34,35].…”

Section: Discussionmentioning

confidence: 99%

“…Large series have reported accuracies of 85 and 75% for EUS determination of tumor (T) classification and node (N) classification, respectively, in patients undergoing surgical resection without prior neoadjuvant therapy [20,21,22]. In contrast, EUS cannot accurately evaluate the T stage after neoadjuvant CRT [23,24,25,26,27,28,29], because inflammation, necrosis, and fibrosis associated with CRT lead to disintegration and blurring of anatomic structures. Moreover, since we cannot obtain accurate histopathologic stage information after definitive CRT, prognosis prediction in these patients is extremely difficult, and there are no well-established prognostic factors for esophageal cancer after definitive CRT.…”

Section: Introductionmentioning

confidence: 99%

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Prediction of Survival by Tumor Area on Endosonography after Definitive Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of the Esophagus

Shim¹,

Song

Lee

et al. 2014

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Background: Definitive chemoradiotherapy (CRT) is a reasonable approach for patients with locally advanced esophageal cancer who are not surgical candidates. This study was performed to investigate whether endosonography (EUS) assessment of tumor area response is a useful prognostic marker in patients with squamous cell carcinoma (SCC) of the esophagus who receive definitive CRT. Methods: A total of 33 patients who received definitive CRT for locally advanced esophageal SCC were enrolled. The maximal transverse cross-sectional area of the tumor was measured before and after definitive therapy. EUS response was defined as a ≥50% reduction of the tumor area after definitive CRT. Results: Based on EUS evaluation, there were 20 nonresponders (60.6%) and 13 responders (39.4%). The median progression-free survival (PFS) was significantly longer in EUS responders than EUS nonresponders (p = 0.005). However, there was no statistical significance in overall survival according to EUS response (p = 0.120). During multivariate analysis, EUS response to definitive CRT was the only significant factor associated with PFS (p = 0.045), whereas EUS response to definitive CRT was not associated with overall survival (p = 0.221). Conclusions: A reduction of the maximal cross-sectional tumor area measured by EUS correlates with a superior prognosis in patients with locally advanced SCC of the esophagus after definitive CRT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prediction of Survival by Tumor Area on Endosonography after Definitive Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of the Esophagus

Shim¹,

Song

Lee

et al. 2014

Digestion

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“…The celiac axis lymph nodes are considered by surgeons to be a regional nodal basin of esophageal carcinomas. The revised TNM staging system has established malignant celiac lymph node involvement as distant metastasis for tumors arising in the thoracic esophagus (stage M1) 2,50 and these patients are therefore not considered candidates for curative surgical resection 51 . This approach is supported by the poor prognosis of these patients 52 .…”

Section: Discussionmentioning

confidence: 99%

Assessment of clinical impact of endoscopic ultrasound on esophageal cancer

Harewood

Kumar

2004

J of Gastro and Hepatol

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“…One problem with EUS specificity in that study of possible recurrences were the false positives reported for anastomotic thickening because of inflammation. Other limitations to EUS include its decreased sensitivity in the presence of stenosis and its unreliability in assessment of the response to neoadjuvant therapy [67,68]. In three studies involving 196 patients, the accuracy of EUS after neoadjuvant therapy ranged from 27%-48% for T staging and 38%-71% for N staging [68][69][70].…”

Section: Staging and Work-upmentioning

confidence: 99%

Multiple Management Modalities in Esophageal Cancer: Epidemiology, Presentation and Progression, Work-up, and Surgical Approaches

et al. 2004

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Annually, approximately 13,200 people in the U.S. are diagnosed with esophageal cancer and 12,500 die of this malignancy. Of new cases, 9,900 occur in men and 3,300 occur in women. In part I of this two-part series, we explore the epidemiology, presentation and progression, work-up, and surgical approaches for esophageal cancer. In the 1960s, squamous cell cancers made up greater than 90% of all esophageal tumors. The incidence of esophageal adenocarcinomas has risen considerably over the past two decades, such that they are now more prevalent than squamous cell cancer in the western hemisphere. Despite advances in therapeutic modalities for this disease, half the patients are incurable at presentation, and overall survival after diagnosis is grim. Evolving knowledge regarding the etiology of esophageal carcinoma may lead to better preventive methods and treatment options for early stage superficial cancers of the esophagus. The use of endoscopic ultrasound and the developing role of positron emission tomography have led to better diagnostic accuracy in this disease. For years, the standard of care for esophageal cancer has been surgery; there are several variants of the surgical approach. We will discuss combined modality approaches in part II of this series. The Oncologist 2004;9:137-146 The Oncologist 2004;9:137-146 www.TheOncologist.com Correspondence: Richard H. Matthews, M.D., Ph.D., Beth Israel/Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, Massachusetts 02215, USA. Telephone: 617-232-9500, ext 4457 or ext 5628; Fax: 617-524-0643; e-mail: RHMatthews@comcast.net Received May 13, 2003; accepted for publication September 18, 2003. ©AlphaMed Press 1083-7159/2004 The Oncologist ® Gastrointestinal Cancer LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Describe the epidemiology, work-up, and staging of esophageal cancer.2. Identify the disease presentation, progression, and prognostic factors for esophageal cancer.3. Discuss the surgical approach and management of esophageal cancer.Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME by guest on April 30, 2019 http://theoncologist.alphamedpress.org/ Downloaded fromThis material is protected by U.S.

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Staging and prognosis using endosonography in patients with inoperable esophageal carcinoma treated with combined intraluminal and external irradiation

Cited by 26 publications

References 26 publications

Prediction of Survival by Tumor Area on Endosonography after Definitive Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of the Esophagus

Prediction of Survival by Tumor Area on Endosonography after Definitive Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of the Esophagus

Assessment of clinical impact of endoscopic ultrasound on esophageal cancer

Multiple Management Modalities in Esophageal Cancer: Epidemiology, Presentation and Progression, Work-up, and Surgical Approaches

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