BACKGROUND: Despite recent advances in imaging techniques, adequate classification of esophageal lesions is still challenging. Accurate staging of tumors of the esophagus is a precondition for targeted therapy. In this retrospective, multicenter study, we report the role of high-frequency endoscopic ultrasound (EUS) catheter probes in pretherapeutic staging of esophageal neoplasms and thus guiding treatment decisions. METHODS: A total of 143 patients (mean age of 63.8 ± 10.7 years) with esophageal carcinoma were recruited from five German centers (Münster, Oldenburg, Hannover, Wiesbaden, and Lüneburg). Tumor type was adenocarcinoma in 112 (78 %) cases and squamous cell carcinoma in 31 (22 %). Tumor localization was as follows: proximal 3, mid esophagus 7, and distal third 133. Histological correlation either through EMR or surgery was available. In all patients, pretherapeutic uT and uN classifications were compared to pT/pN classification obtained from surgically (esophagectomy, n = 93) or endoscopically (EMR, n = 50) resected tissue. RESULTS: Overall, accuracy of uT classification was 60 % and of uN classification was 74 %. Sensitivity, specificity, and accuracy rates for local tumor extension were as follows (%): T1: 68/97/83; T2: 39/84/75; T3: 72/81/79; T4: 13/97/93; T1/2: 73/81/75; T3/4: 78/82/81. Relating to positive lymph node detection, sensitivity and specificity were 76 and 71 %, respectively. CONCLUSIONS: Miniprobe EUS is an established method for the staging of esophageal tumors. Our large multicenter cohort shows a solid accuracy of miniprobe EUS with respect to differentiating locally advanced from limited cancer and assisting to determine the treatment regimen in the era of neoadjuvant therapy; consequently, 78 % of patients would have been assigned to the adequate therapeutic regimen, whereas 11 % of patients would have been overtreated and 11 % undertreated.
BACKGROUND: Despite recent advances in imaging techniques, adequate classification of esophageal lesions is still challenging. Accurate staging of tumors of the esophagus is a precondition for targeted therapy. In this retrospective, multicenter study, we report the role of high-frequency endoscopic ultrasound (EUS) catheter probes in pretherapeutic staging of esophageal neoplasms and thus guiding treatment decisions. METHODS: A total of 143 patients (mean age of 63.8 ± 10.7 years) with esophageal carcinoma were recruited from five German centers (Münster, Oldenburg, Hannover, Wiesbaden, and Lüneburg). Tumor type was adenocarcinoma in 112 (78 %) cases and squamous cell carcinoma in 31 (22 %). Tumor localization was as follows: proximal 3, mid esophagus 7, and distal third 133. Histological correlation either through EMR or surgery was available. In all patients, pretherapeutic uT and uN classifications were compared to pT/pN classification obtained from surgically (esophagectomy, n = 93) or endoscopically (EMR, n = 50) resected tissue. RESULTS: Overall, accuracy of uT classification was 60 % and of uN classification was 74 %. Sensitivity, specificity, and accuracy rates for local tumor extension were as follows (%): T1: 68/97/83; T2: 39/84/75; T3: 72/81/79; T4: 13/97/93; T1/2: 73/81/75; T3/4: 78/82/81. Relating to positive lymph node detection, sensitivity and specificity were 76 and 71 %, respectively. CONCLUSIONS: Miniprobe EUS is an established method for the staging of esophageal tumors. Our large multicenter cohort shows a solid accuracy of miniprobe EUS with respect to differentiating locally advanced from limited cancer and assisting to determine the treatment regimen in the era of neoadjuvant therapy; consequently, 78 % of patients would have been assigned to the adequate therapeutic regimen, whereas 11 % of patients would have been overtreated and 11 % undertreated.
Authors: Jacques J G H M Bergman; Yue-Ming Zhang; Shun He; Bas Weusten; Liyan Xue; David E Fleischer; Ning Lu; Sanford M Dawsey; Gui-Qi Wang Journal: Gastrointest Endosc Date: 2011-08-15 Impact factor: 9.427
Authors: Val J Lowe; Fargol Booya; J G Fletcher; Mark Nathan; Eric Jensen; Brian Mullan; Eric Rohren; Maurits J Wiersema; Enrique Vazquez-Sequeiros; Joseph A Murray; Mark S Allen; Michael J Levy; Jonathan E Clain Journal: Mol Imaging Biol Date: 2005 Nov-Dec Impact factor: 3.488
Authors: J F Bosset; M Gignoux; J P Triboulet; E Tiret; G Mantion; D Elias; P Lozach; J C Ollier; J J Pavy; M Mercier; T Sahmoud Journal: N Engl J Med Date: 1997-07-17 Impact factor: 91.245
Authors: Julian A Abrams; Donna L Buono; Joshua Strauss; Russell B McBride; Dawn L Hershman; Alfred I Neugut Journal: Cancer Date: 2009-11-01 Impact factor: 6.860
Authors: S Takashima; N Takeuchi; H Shiozaki; K Kobayashi; S Morimoto; J Ikezoe; N Tomiyama; K Harada; K Shogen; T Kozuka Journal: AJR Am J Roentgenol Date: 1991-02 Impact factor: 3.959
Authors: Jung Im Jung; Gwang Ha Kim; Hoseok I; Do Youn Park; Tae Kyun Kim; Young Hwa Cho; Yong Wan Sung; Mun Ki Choi; Bong Eun Lee; Geun Am Song Journal: World J Gastroenterol Date: 2014-05-28 Impact factor: 5.742