BACKGROUND: Although studies have shown that EUS has a high sensitivity and specificity for T and N staging, the value of EUS for staging tumors as resectable or nonresectable after CT of the chest and abdomen and US neck assessment, is largely unknown. This study was designed to assess the diagnostic value of EUS for determining resectability of esophageal cancer. METHODS: A retrospective analysis of all consecutive patients with esophageal carcinoma who underwent staging EUS, CT, and US. Tumors were considered resectable when there was no evidence of metastases or ingrowth in adjacent structures. Sensitivity, specificity, positive (PPV), and negative (NPV) predictive value of CT/US neck and CT/US neck + EUS for predicting surgical resectability were calculated. PPVs of CT/US alone and CT/US + EUS together were compared for assessing the diagnostic value of EUS. RESULTS: In total, 211 patients (155 men; mean age of 64 ± 9.4 years) were included, of which 176 (83 %) underwent all three staging investigations. Based on preoperative staging, 173 (82 %) patients were considered resectable and 38 (18 %) nonresectable. Of all 173 initially resectable patients, 145 were operated on. Of these patients, five (3.4 %) tumors were found nonresectable during surgery. Postoperative sensitivity, specificity, PPV, and NPV of CT/US and CT/US + EUS for predicting surgical resectability were 88 versus 87 %, 20 versus 40 %, 97 versus 98 %, and 6 versus 10 %, respectively. CONCLUSIONS: Although EUS adds to the specificity of preoperative esophageal cancer staging after CT chest and abdomen, and US of the neck have been performed, the overall added value of EUS is limited.
BACKGROUND: Although studies have shown that EUS has a high sensitivity and specificity for T and N staging, the value of EUS for staging tumors as resectable or nonresectable after CT of the chest and abdomen and US neck assessment, is largely unknown. This study was designed to assess the diagnostic value of EUS for determining resectability of esophageal cancer. METHODS: A retrospective analysis of all consecutive patients with esophageal carcinoma who underwent staging EUS, CT, and US. Tumors were considered resectable when there was no evidence of metastases or ingrowth in adjacent structures. Sensitivity, specificity, positive (PPV), and negative (NPV) predictive value of CT/US neck and CT/US neck + EUS for predicting surgical resectability were calculated. PPVs of CT/US alone and CT/US + EUS together were compared for assessing the diagnostic value of EUS. RESULTS: In total, 211 patients (155 men; mean age of 64 ± 9.4 years) were included, of which 176 (83 %) underwent all three staging investigations. Based on preoperative staging, 173 (82 %) patients were considered resectable and 38 (18 %) nonresectable. Of all 173 initially resectable patients, 145 were operated on. Of these patients, five (3.4 %) tumors were found nonresectable during surgery. Postoperative sensitivity, specificity, PPV, and NPV of CT/US and CT/US + EUS for predicting surgical resectability were 88 versus 87 %, 20 versus 40 %, 97 versus 98 %, and 6 versus 10 %, respectively. CONCLUSIONS: Although EUS adds to the specificity of preoperative esophageal cancer staging after CT chest and abdomen, and US of the neck have been performed, the overall added value of EUS is limited.
Authors: Roos E Pouw; Noor Heldoorn; Lorenza Alvarez Herrero; Fiebo J W ten Kate; Mike Visser; Olivier R Busch; Mark I van Berge Henegouwen; Kausilia K Krishnadath; Bas L Weusten; Paul Fockens; Jacques J Bergman Journal: Gastrointest Endosc Date: 2011-01-26 Impact factor: 9.427
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Authors: W A Marsman; M A Brink; J J Bergman; G N Tytgat; F J ten Kate; J J van Lanschot; P Fockens Journal: Endoscopy Date: 2006-08 Impact factor: 10.093
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Authors: Peter S N van Rossum; Richard van Hillegersberg; Frederiek M Lever; Irene M Lips; Astrid L H M W van Lier; Gert J Meijer; Maarten S van Leeuwen; Marco van Vulpen; Jelle P Ruurda Journal: Eur Radiol Date: 2013-02-13 Impact factor: 5.315
Authors: Peter S N van Rossum; Cai Xu; David V Fried; Lucas Goense; Laurence E Court; Steven H Lin Journal: Transl Cancer Res Date: 2016-08 Impact factor: 1.241
Authors: J B Hulshoff; V E M Mul; H E M de Boer; W Noordzij; T Korteweg; H M van Dullemen; W B Nagengast; V Oppedijk; J P E N Pierie; John Th M Plukker Journal: Ann Surg Oncol Date: 2017-03-16 Impact factor: 5.344