Endosonography and computed tomography of esophageal carcinoma. Preoperative classification compared to the new (1987) TNM system.

Transesophageal endosonography and computed tomography were performed preoperatively in 74 patients with an esophageal carcinoma. The results were correlated with the histology of resected specimens according to the new (1987) TNM classification. Endosonography was superior to computed tomography in the evaluation of the depth of tumor infiltration, especially in the early stages and in nonresectable carcinoma (overall accuracy: endosonography 89%, computed tomography 59%). Endosonography was also more accurate than computed tomography in the assessment of regional lymph node metastases (overall accuracy: endosonography 80%, computed tomography 51%). The incidence of lymph node metastasis increased with the progression of the depth of tumor infiltration. The definitive exclusion factor for endosonography is severe stenosis, which cannot be passed with the instrument (26% of the cases). In these cases computed tomography was superior to endosonography in diagnosing celiac lymph node metastasis (overall accuracy: computed tomography 82%, endosonography 68%).