BACKGROUND: Endoscopic ultrasound (EUS) is known to detect smaller effusion volumes than computerised tomography (CT), yet the outcomes for patients diagnosed with oesophageal carcinoma and EUS-defined pleural, pericardial or ascitic fluid effusions (EDFE) are unknown. The aim of this study was to determine the outcome of multidisciplinary stage directed treatment for such patients. METHODS: Forty-nine (9.2%) out of a consecutive 527 patients diagnosed with oesophageal cancer from a single regional upper gastrointestinal (GI) cancer network were found to have evidence of EDFE undetected by CT. Thirty-nine (79.6%) patients had pleural effusions, eight (16.3%) pericardial effusions, and two (4.1%) ascites. RESULTS: Twelve (24.4%) underwent surgery, 3 (6.1%) received neoadjuvant chemotherapy without subsequent surgery, 12 (24.5%) received definitive chemoradiotherapy (dCRT), and 22 (44.9%) received palliative treatment. Survival in patients with EDFE was significantly shorter (median and 2-year survival 15.6 months and 24%, respectively) when compared with patients without EDFE (26.7 months and 40%, respectively, p = 0.001), and was unrelated to EDFE type (p = 0.192). Two-year survival after oesophagectomy with or without neoadjuvant therapy was 45% in patients with EDFE compared with 42% in patients without EDFE (p = 0.668). CONCLUSIONS: EDFE was an important adverse prognostic indicator, but patients deemed to have operable tumours should still be treated with radical intent.
BACKGROUND: Endoscopic ultrasound (EUS) is known to detect smaller effusion volumes than computerised tomography (CT), yet the outcomes for patients diagnosed with oesophageal carcinoma and EUS-defined pleural, pericardial or ascitic fluid effusions (EDFE) are unknown. The aim of this study was to determine the outcome of multidisciplinary stage directed treatment for such patients. METHODS: Forty-nine (9.2%) out of a consecutive 527 patients diagnosed with oesophageal cancer from a single regional upper gastrointestinal (GI) cancer network were found to have evidence of EDFE undetected by CT. Thirty-nine (79.6%) patients had pleural effusions, eight (16.3%) pericardial effusions, and two (4.1%) ascites. RESULTS: Twelve (24.4%) underwent surgery, 3 (6.1%) received neoadjuvant chemotherapy without subsequent surgery, 12 (24.5%) received definitive chemoradiotherapy (dCRT), and 22 (44.9%) received palliative treatment. Survival in patients with EDFE was significantly shorter (median and 2-year survival 15.6 months and 24%, respectively) when compared with patients without EDFE (26.7 months and 40%, respectively, p = 0.001), and was unrelated to EDFE type (p = 0.192). Two-year survival after oesophagectomy with or without neoadjuvant therapy was 45% in patients with EDFE compared with 42% in patients without EDFE (p = 0.668). CONCLUSIONS:EDFE was an important adverse prognostic indicator, but patients deemed to have operable tumours should still be treated with radical intent.
Authors: D J Bowrey; G W Clark; S A Roberts; T S Maughan; A B Hawthorne; G T Williams; P D Carey Journal: Dis Esophagus Date: 1999 Impact factor: 3.429
Authors: Gregory Zuccaro; Thomas W Rice; John J Vargo; John R Goldblum; Lisa A Rybicki; John A Dumot; David J Adelstein; Patricia A Trolli; Eugene H Blackstone Journal: Am J Gastroenterol Date: 2005-03 Impact factor: 10.864
Authors: M A Morgan; W G Lewis; T D L Crosby; X Escofet; S A Roberts; A E Brewster; T J Harvard; G W B Clark Journal: Br J Surg Date: 2007-12 Impact factor: 6.939
Authors: M A Morgan; W G Lewis; A N Hopper; X Escofet; T J Havard; A E Brewster; T D L Crosby; S A Roberts; G W B Clark Journal: Dis Esophagus Date: 2007 Impact factor: 3.429