BACKGROUND AND STUDY AIMS: Esophageal invasion by carcinoma of the cardia may affect the surgical approach. Accurate assessment of esophageal invasion is difficult using endoscopy, computed tomography, or barium contrast radiography. The aim of the present study was to evaluate the use of endoscopic ultrasonography (EUS) in the prediction of esophageal invasion by carcinoma of the cardia. PATIENTS AND METHODS: EUS (using a linear-array scanner) was carried out prospectively in 47 patients with carcinoma of the cardia who underwent subsequent surgical resection. The findings were correlated with the histopathological assessment of tumor infiltration in the esophagus in the resected specimen. RESULTS: An absence of esophageal invasion was correctly predicted by EUS in 12 of 13 patients. Histopathologically confirmed invasion of the esophagus was correctly predicted in 32 of 34 patients. With a margin of error of 10 mm, the accuracy of EUS in predicting or excluding histologically confirmed invasion of the esophagus was 85.1% (40 of 47 patients). False-positive results with EUS occurred in patients with prominent edematous or fibrous changes in the distal esophagus; false-negative results with EUS were seen in patients with scattered infiltration of a small number of tumor cells into the mucosal or submucosal layer. CONCLUSIONS: EUS can provide the surgeon with additional information on the extent of esophageal infiltration in patients with carcinoma of the gastric cardia, and can therefore assist in the selection of the surgical approach.
BACKGROUND AND STUDY AIMS: Esophageal invasion by carcinoma of the cardia may affect the surgical approach. Accurate assessment of esophageal invasion is difficult using endoscopy, computed tomography, or barium contrast radiography. The aim of the present study was to evaluate the use of endoscopic ultrasonography (EUS) in the prediction of esophageal invasion by carcinoma of the cardia. PATIENTS AND METHODS: EUS (using a linear-array scanner) was carried out prospectively in 47 patients with carcinoma of the cardia who underwent subsequent surgical resection. The findings were correlated with the histopathological assessment of tumor infiltration in the esophagus in the resected specimen. RESULTS: An absence of esophageal invasion was correctly predicted by EUS in 12 of 13 patients. Histopathologically confirmed invasion of the esophagus was correctly predicted in 32 of 34 patients. With a margin of error of 10 mm, the accuracy of EUS in predicting or excluding histologically confirmed invasion of the esophagus was 85.1% (40 of 47 patients). False-positive results with EUS occurred in patients with prominent edematous or fibrous changes in the distal esophagus; false-negative results with EUS were seen in patients with scattered infiltration of a small number of tumor cells into the mucosal or submucosal layer. CONCLUSIONS: EUS can provide the surgeon with additional information on the extent of esophageal infiltration in patients with carcinoma of the gastric cardia, and can therefore assist in the selection of the surgical approach.
Authors: Christoph F Dietrich; Paolo Giorgio Arcidiacono; Barbara Braden; Sean Burmeister; Silvia Carrara; Xinwu Cui; Milena Di Leo; Yi Dong; Pietro Fusaroli; Uwe Gottschalk; Andrew J Healey; Michael Hocke; Stephan Hollerbach; Julio Iglesias Garcia; André Ignee; Christian Jürgensen; Michel Kahaleh; Masayuki Kitano; Rastislav Kunda; Alberto Larghi; Kathleen Möller; Bertrand Napoleon; Kofi W Oppong; Maria Chiara Petrone; Adrian Saftoiu; Rajesh Puri; Anand V Sahai; Erwin Santo; Malay Sharma; Assaad Soweid; Siyu Sun; Anthony Yuen Bun Teoh; Peter Vilmann; Hans Seifert; Christian Jenssen Journal: Endosc Ultrasound Date: 2019 Nov-Dec Impact factor: 5.628
Authors: Magdy S Kandil; Shouki N Bazarbashi; Mohammed M Rahal; Ahmed S Al-Shehri; Ali M Alzahrani; Ali H Aljubran; Jamal E Zekri; Ashwaq A Al Olayan; Abdullah A Alsharm; Nizar M Yamani; Ibrahim S Alomary; Mosa A Fagih Journal: Saudi Med J Date: 2014-12 Impact factor: 1.484