HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Laterza, E. Articles by Cordiano, C. Search for Related Content PubMed PubMed Citation Articles by Laterza, E. Articles by Cordiano, C.

Ann Thorac Surg 1999;67:1466-1469
© 1999 The Society of Thoracic Surgeons

---

Original Articles

Endoscopic ultrasonography in the staging of esophageal carcinoma after preoperative radiotherapy and chemotherapy

^a First Division of General Surgery, University of Verona, Verona, Italy

Accepted for publication December 4, 1998.

Address reprint requests to Dr de Manzoni, 1st Department of General Surgery, Borgo Trento Hospital, Piazza Stefani 1, 37126 Verona, Italy

Background. In past years multimodal neoadjuvant treatment for carcinoma of the esophagus has been used with increased frequency. Staging of the neoplasm still remains fundamental in evaluating the response to therapy and in planning operation. The aim of the present study was to assess the accuracy of endoscopic ultrasonography (EUS) in a group of patients with squamous cell carcinoma of the thoracic esophagus after undergoing radiotherapy and chemotherapy.

Methods. Among a group of 111 patients with squamous cell carcinoma of the thoracic esophagus and treated with preoperative radiotherapy and chemotherapy, 87 were operated. In these patients it was possible to compare the results of EUS, with regard to depth of invasion of esophageal wall (T) and lymph node involvement (N), with the results of operation and histopathologic study.

Results. Feasibility of EUS before and after neoadjuvant treatment was 71.2% and 83.9%, respectively. The overall accuracy of EUS regarding the wall invasion was 47.9%. The more frequent error was overstaging, especially in patients with complete response and in patients with minimal residual disease. In the assessment of lymph node involvement, EUS showed an overall accuracy of 71.2% with a moderate value. Sensitivity for N1 and N0 was 73.7% and 68.6%, respectively.

Conclusions. Endoscopic ultrasonography was feasible in most patients after preoperative radiotherapy and chemotherapy, but our study documented a worsening of accuracy of EUS in the evaluation of T attributable to the confounding presence of radiation fibrosis and soft tissue reaction after radiotherapy and chemotherapy.

This article has been cited by other articles:

				I. Higuchi, T. Yasuda, M. Yano, Y. Doki, H. Miyata, M. Tatsumi, H. Fukunaga, S. Takiguchi, Y. Fujiwara, J. Hatazawa, et al. Lack of fludeoxyglucose F 18 uptake in posttreatment positron emission tomography as a significant predictor of survival after subsequent surgery in multimodality treatment for patients with locally advanced esophageal squamous cell carcinoma J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 205 - 212. [Abstract] [Full Text] [PDF]

				X.-B. D'Journo, P. Michelet, L. Dahan, C. Doddoli, J.-F. Seitz, R. Giudicelli, P. A. Fuentes, and P. A. Thomas Indications and outcome of salvage surgery for oesophageal cancer Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 1117 - 1123. [Abstract] [Full Text] [PDF]

				G. Piessen, N. Briez, J.-P. Triboulet, and C. Mariette Patients with Locally Advanced Esophageal Carcinoma Nonresponder to Radiochemotherapy: Who Will Benefit From Surgery? Ann. Surg. Oncol., July 1, 2007; 14(7): 2036 - 2044. [Abstract] [Full Text] [PDF]

				M. Westerterp, H. L. van Westreenen, J. B. Reitsma, O. S. Hoekstra, J. Stoker, P. Fockens, P. L. Jager, B. L. F. Van Eck-Smit, J. T. M. Plukker, J. J. B. van Lanschot, et al. Esophageal Cancer: CT, Endoscopic US, and FDG PET for Assessment of Response to Neoadjuvant Therapy--Systematic Review Radiology, September 1, 2005; 236(3): 841 - 851. [Abstract] [Full Text] [PDF]

				C. J. Lightdale and K. G. Kulkarni Role of Endoscopic Ultrasonography in the Staging and Follow-Up of Esophageal Cancer J. Clin. Oncol., July 10, 2005; 23(20): 4483 - 4489. [Abstract] [Full Text] [PDF]

				R. J. Cerfolio, A. S. Bryant, B. Ohja, A. A. Bartolucci, and M. A. Eloubeidi The accuracy of endoscopic ultrasonography with fine-needle aspiration, integrated positron emission tomography with computed tomography, and computed tomography in restaging patients with esophageal cancer after neoadjuvant chemoradiotherapy J. Thorac. Cardiovasc. Surg., June 1, 2005; 129(6): 1232 - 1241. [Abstract] [Full Text] [PDF]

				M. Koshy, N. Esiashvilli, J. C. Landry, C. R. Thomas Jr., and R. H. Matthews Multiple Management Modalities in Esophageal Cancer: Epidemiology, Presentation and Progression, Work-up, and Surgical Approaches Oncologist, April 1, 2004; 9(2): 137 - 146. [Abstract] [Full Text] [PDF]

				M. RIEDEL, H. J. STEIN, L. MOUNYAM, F. ZIMMERMANN, U. FINK, and J. R. SIEWERT Influence of Simultaneous Neoadjuvant Radiotherapy and Chemotherapy on Bronchoscopic Findings and Lung Function in Patients with Locally Advanced Proximal Esophageal Cancer Am. J. Respir. Crit. Care Med., November 1, 2000; 162(5): 1741 - 1746. [Abstract] [Full Text]