Leeder, P.C.; Dehn, T.C.B.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA48
Academic Journal
Aim: Following recent government recommendations regarding the management of patients with oesophageal cancer, it was useful to evaluate the process of sequential staging for patients with oesophageal cancer. Methods: Patients admitted with a diagnosis of oesophageal cancer between 1996 and 2001 were included in the study. Data were collected prospectively. All patients considered for surgery embarked on sequential staging with computerised tomography (CT), followed by endoluminal ultrasound (introduced at the end of 1998), then Ioparoscopy. Results: A total of 244 patients were admitted over the six-year period. Seventy-three patients (30%) were turned down for surgery because of high operative risk, while seven (3%) refused the offer of surgery. The remaining 164 patients went on to have staging CT. Thirty-eight patients were refused surgery because of metastatic spread seen on CT. Of 46 patients undergoing endoluminal ultrasound, nine were refused surgery because of signs of widespread disease. Thirty-five of 118 patients (30%) were denied surgery on the grounds of findings at staging laparoscopy. A total of 85 patients underwent resection (35%). Thirty-five patients were given preoperative chemotherapy. In two patients attempted resection was abandoned because of local spread. Patients who did not undergo surgery were referred For either radical chemoradiotherapy (ten) or palliative treatment. Conclusions: It is important to select those patients who are most likely to benefit From surgery and to avoid incomplete resection. Three modality, sequential staging is an invaluable tool in this process of patient selection for oesophageal resection.


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