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Ann Thorac Surg 1999;68:2059-2064
© 1999 The Society of Thoracic Surgeons
a First Department of Surgery, School of Medicine, Niigata University, Niigata, Tokyo, Japan
b Department of Surgery, Niigata Cancer Center Hospital, Niigata, Japan
c Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
d Department of Surgery, Tokyo Women’s Medical College, Tokyo, Japan
e Department of Surgery, National Cancer Center Hospital, Tokyo, Japan
f Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
g Department of Surgery, National Shikoku Cancer Center Hospital, Matsuyama, Japan
h First Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
i First Department of Surgery, Iwate Medical College, Morioka, Japan
j Second Department of Surgery, Faculty of Medicine, Chiba University, Chiba, Japan
k First Department of Surgery, School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
l Department of Surgery, National Tokyo Second Hospital, Tokyo, Japan
m Department of Surgery, School of Medicine, Tokai University, Isehara, Japan
n Department of Surgery, Kanagawa Cancer Center Hospital, Yokohama, Japan
o First Department of Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan
p National Oji Hospital, Tokyo, Japan
Address reprint requests to Dr Nishimaki, First Department of Surgery, Niigata University School of Medicine, Asahimachi-dori 1-757, Niigata 951, Japan
Abstract
Background. Exact clinical staging before treatment of esophageal cancer has become increasingly important in the evaluation and comparison of the results of different treatment modalities, including surgery, chemotherapy, and radiotherapy.
Methods. The accuracy of preoperative tumor staging by using an esophagography, esophagoscopy, percutaneous and endoscopic ultrasonography, and computed tomography was assessed in 224 patients with resectable esophageal cancer. The results of tumor staging by these tests were compared prospectively with the pathologic stage of the esophagectomy specimens with respect to the T and N categories defined by the International Union Against Cancer TNM classification.
Results. For the T category, the overall accuracy was 80%. For the N category, overall accuracy was 72%, with a sensitivity of 78%, a specificity of 60%, and a positive predictive value of 78%. Overall, the accuracy of stage grouping was 56%.
Conclusions. Either the T or N categories can be predicted reliably by clinical staging techniques. However, the preoperative stage grouping might not be valid in resectable, localized esophageal cancer.
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