Accuracy of staging in early oesophageal cancer using high resolution endoscopy and high resolution endosonograpny: a comparative, prospective, and blinded trial

May, A.; Günter, E.; Roth, F.; Gossner, I.; Stolte, M.; Vieth, M.; Eli, C.
May 2004
Gut;May2004, Vol. 53 Issue 5, p634
Academic Journal
Background and aims: The increasing use of endoscopic resection for curative treatment of early oesophageal cancers requires accurate staging before therapy. In a prospective blinded trial, we compared staging of early oesophageal carcinoma using high resolution endoscopy (HR-E) with staging using high resolution endosonography (HR-EUS). Patients and methods: A total of 100 patients (89 men, 11 women; mean age 63.9(10.8) years (range 31-91)) with a suspicion of early oesophageal adenocarcinoma (n = 81) or squamous cell carcinoma (n = 19) were enrolled in the study. After endoscopic staging with high resolution video endoscopy by two experienced endoscopists, HR-EUS was performed by an experienced endosonographer who was blinded to the endoscopic assessment. Results of the staging examinations were correlated with the histology of the resected tumours. Results: Overall rates for accuracy of the endoscopic and endosonographic staging were 83.4% and 79.6%, respectively. Sensitivity for mucosal tumours (n = 68) was more than 90% (EUS 91.2%, endoscopy 94.1%) while sensitivity for submucosal tumours (n = 25) was lower, at 48% for EUS and 56% for endoscopic staging. A combination of the two techniques increased the sensitivity for submucosal tumours to 60%. Submucosal tumours in the tubular oesophagus were significantly better staged with HR-EUS than submucosal tumours close to the oesophagogastric junction (10/11 v 2/14; p<0.00l). Tumours infiltrating the second and third submucosal layers were also more correctly diagnosed than tumours with slight infiltration of the first submucosal layer (sm1). Conclusions: The overall diagnostic accuracy of both HR-E and HR-EUS with a 20 MHz miniprobe in early oesophageal cancer was high (approximately 80%), with no significant differences between the two techniques. HR-E and HR-EUS provide a high level of diagnostic accuracy for mucosal tumours and submucosal tumours located in the tubular part of the oesophagus.


Related Articles

  • Diffuse esophageal leiomyomatosis with a pedunculated polyp. Kuo, Ming-Jeng; Yeh, Hong-Zen; Chen, Gran-Hum; Jan, Yee-Jee // Journal of Gastroenterology;2004, Vol. 39 Issue 12, p1205 

    Although leiomyomas are the most common benign tumors of the esophagus, esophageal leiomyomatosis is a rare pathological entity, and pedunculated presentation is even rarer. A 61-year-old man was found, incidentally, to have an esophageal tumor on a survey of chest computed tomography (CT)...

  • Endoscopic ultrasound in the diagnosis and staging of lung cancer. Colella, Sara; Vilmann, Peter; Konge, Lars; Clementsen, Paul Frost // Endoscopic Ultrasound;Oct-Dec2014, Vol. 3 Issue 4, p205 

    No abstract available.

  • Growth process of small pancreatic carcinoma: A case report with imaging observation for 22 months. Hisa, Takeshi; Ohkubo, Hiroki; Shiozawa, Satoshi; Ishigame, Hiroki; Takamatsu, Masato; Furutake, Masayuki; Nobukawa, Bunsei; Suda, Koichi; Pezzilli, Raffaele // World Journal of Gastroenterology;3/28/2008, Vol. 14 Issue 12, p1958 

    This report describes serial observations of the growth process of a small invasive ductal carcinoma (IDC) of the pancreas from imaging studies. Histopathological studies showed IDC with macroscopic retention cysts proximal to an intraductal papillary-mucinous adenoma with mild atypia of the...

  • Clinical Application of Endoscopic Ultrasonography. Nickl, Nicholas J.; Cotton, Peter B. // American Journal of Gastroenterology;Jun1990, Vol. 85 Issue 6, p675 

    During the course of routine clinical practice in 48 patients, 50 endoscopic ultrasound (EUS) examinations were performed over a 1-yr period, with all patient data collected prospectively. Organs examined were the esophagus, stomach, duodenum, ampulla, pancreas, common bile duct, and...

  • Endosonography of upper gastrointestinal tract cancer on demand using miniprobes or endoscopic ultrasound. Hünerbein, M.; Ulmer, C.; Handke, T.; Schlag, P.M.; Hünerbein, M // Surgical Endoscopy;Apr2003, Vol. 17 Issue 4, p615 

    Background: The aim of this study was to investigate whether endosonography on demand with miniprobes and conventional endoscopic ultrasound improves the accuracy of endosonographic staging of upper gastrointestinal tract cancer. Methods: Altogether, 173 patients...

  • Endoscopic polypectomy: A promising therapeutic choice for esophageal carcinosarcoma. Feng Ji; Yue-Mei Xu; Cheng-Fu Xu; Nakagawa, Hiroshi // World Journal of Gastroenterology;7/21/2009, Vol. 15 Issue 27, p3448 

    Esophageal carcinosarcoma is a rare malignant tumor composing of both carcinomatous and sarcomatous elements. Endoscopic therapy is less invasive and may represent an alternative to esophagectomy for superficial esophageal carcinosarcoma. Here, we report a 61-year-old male who was diagnosed as...

  • Endoscopic therapy using an endoscopic variceal ligation for minute cancer of the esophagogastric junction complicated with esophageal varices: a case report. Akiyama, Tomoyuki; Abe, Yasunobu; Iida, Hiroshi; Endo, Hiroki; Hosono, Kunihiro; Yoneda, Kyoko; Takahashi, Hirokazu; Inamori, Masahiko; Ryo, Akihide; Yamanaka, Shoji; Inayama, Yoshiaki; Nakajima, Atsushi // Journal of Medical Case Reports;2010, Vol. 4 Issue 1, p1 

    Introduction: Standard endoscopic mucosal resection or endoscopic submucosal dissection is a procedure for patients with minute cancers, complicated with esophageal varices that puts them at high risk of bleeding. Case presentation: We present the case of a 77-year-old Japanese man with...

  • Diagnosis and Staging of Tumors by Laparoscopy. Cuschieri, Alfred // Seminars in Laparoscopic Surgery;Mar1994, Vol. 1 Issue 1, p3 

    The reported experience over several decades from various surgical specialties indicate that laparoscopy is useful both in the diagnosis and staging of intra-abdominal tumors. The staging potential has been enhanced by the introduction of laparoscopic contact ultrasonography that is of special...

  • Modified endoscopic submucosal dissection with enucleation for treatment of gastric subepithelial tumors originating from the muscularis propria layer. Chu, Yin-Yi; Lien, Jau-Min; Tsai, Ming-Hung; Chiu, Cheng-Tang; Chen, Tse-Ching; Yang, Kuo-Ching; Ng, Soh-Ching // BMC Gastroenterology;2012, Vol. 12 Issue 1, p124 

    Background: Gastric subepithelial tumors are usually asymptomatic and observed incidentally during endoscopic examination. Although most of these tumors are considered benign, some have a potential for malignant transformation, particularly those originating from the muscularis propria layer....


Read the Article


Sign out of this library

Other Topics