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Ann Thorac Surg 1984;38:479-481
© 1984 The Society of Thoracic Surgeons

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Articles

The Questionable Role of Computed Tomography in Preoperative Staging of Esophageal Cancer

Department of Cardiac and Thoracic Surgery, Vanderbilt University and Veterans Administration Hospitals, Nashville, TN.

¹ Address reprint requests to Dr. Bender, 338 Medical Arts Bldg, 1211 21st Ave S, Nashville, TN 37212.

The findings of computed tomography (CT) in 18 patients with histologically proven esophageal carcinoma were compared with operative and pathological findings. Computed tomography delineated esophageal lesions in 14 of the 18 patients. In 11 patients, CT scanning was found to be inaccurate in assessing tumor involvement of esophageal lymphatic drainage. Nine patients had no abdominal nodal metastasis demonstrated by CT scan. Operative exploration revealed tumor involvement of celiac or left gastric lymph nodes in all of these patients. Two patients' CT scans demonstrated tumor involvement of celiac and left gastric lymph nodes; at operative exploration, these nodes were enlarged, but they were histologically negative for esophageal carcinoma. Operative exploration changed the preoperative TNM classification in 8 of the 11 patients. Review of these data indicates that surgical exploration continues to be the only reliable method of determining the actual extent and often the resectability of esophageal carcinoma.

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