Assessing operability in squamous carcinoma of the oesophagus. Are pre-operative investigations unreliable?

Pre-operative investigations, although providing useful information, were unreliable in predicting resectability in patients with malignant oesophageal lesions. Chest radiographs excluded metastasis and active tuberculosis. The barium swallow examination determined the length of the lesion and displayed various displacements, none of which excluded resectability. Tumour infiltration of the airways was the only change visible at bronchoscopy that contraindicated resection. Computed axial tomography was unreliable in excluding extra-oesophageal tumour extension and operability. As all these pre-operative investigations have their limitations in assessing operability, exploration of the lesion is essential to determine resectability for squamous carcinoma of the oesophagus, provided there is prior histological confirmation of a malignant oesophageal lesion.