The useful combination of a higher frequency miniprobe and endoscopic submucosal dissection for the treatment of T1 esophageal cancer

Abstract

A higher frequency miniprobe is useful for the detailed evaluation of cancer depth, contributing to decision making for treatment options of T1 esophageal cancer. A miniprobe and echoendoscope in combination with ESD provide an appropriately tailored management plan on an individual basis, avoiding unnecessary treatment or indicating radical surgery.

Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review

“…For example, if EUS demonstrates that a patient has T1 stage disease, the odds of having the correct anatomic stage of T1 disease is 221 to 1. This helps physicians offer endoscopic treatment with confidence to patients with early disease [81][82][83][84][85][86][87] . Another way of looking at this is: if a small lesion is found to be esophageal cancer, then EUS is an excellent diagnostic test to examine the depth of tumor invasion, because of its very high sensitivity and specificity.…”

“…Another way of looking at this is: if a small lesion is found to be esophageal cancer, then EUS is an excellent diagnostic test to examine the depth of tumor invasion, because of its very high sensitivity and specificity. The depth of tumor invasion can help decide if curative surgical or curative endoscopic mucosal resection or submucosal dissection can be offered to resect the lesion en bloc [81][82][83][84][85][86][87] .…”

“…Clinically, another viewpoint is: if EUS diagnoses T2 disease then the patient might still have anatomic T1 disease, but if EUS diagnoses T1 disease then the patient probably truly has anatomic T1 disease. This helps physicians offer surgical or endoscopic treatments with confidence if EUS diagnoses a patient with T1 esophageal cancer [81][82][83][84][85][86][87] . The major advantage of EUS is the ability to perform FNA during the procedure for tissue diagnosis.…”

“…With EUS emerging as a very useful staging tool, its role in staging esophageal cancer continues to be addressed. Several studies have identified the potential benefits of EUS with esophageal cancer staging; however, results regarding the extent of its benefits have been inconsistent [52,72,82] . We conducted a meta-analysis to examine the role of EUS in the staging of esophageal cancer for loco-regional spread.…”

Endoscopic Ultrasound, Where Are We Now in 2012?

“…High frequency miniprobe demonstrates well defined nine-layered structure of esophageal wall, which is in good correspondence with histological layers and provides high accuracy in decision making process for the selection of treatment options of early esophageal cancer. Shimoyama et al6 performed EUS with 12 to 20 MHz miniprobes for T staging and they were able to select correctly all candidates of endoscopic therapy. But there are also other conflicting studies insisting EUS does not appear to be sufficiently accurate in T staging 7.…”