Comparison of endoscopic ultrasonography (EUS), positron emission tomography (PET), and computed tomography (CT) in the preoperative locoregional staging of resectable esophageal cancer

• Published in: Surgical endoscopy Vol. 24; no. 6; pp. 1380 - 1386
• Main Authors: Choi, Jeongmin, Kim, Sang Gyun, Kim, Joo Sung, Jung, Hyun Chae, Song, In Sung
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.06.2010; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Adenocarcinoma - diagnosis; Adenocarcinoma - surgery; Biological and medical sciences; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - surgery; Carcinosarcoma - diagnosis; Carcinosarcoma - surgery; Diagnosis, Differential; Digestive system. Abdomen; Endoscopy; Endosonography - methods; Esophageal Neoplasms - diagnosis; Esophageal Neoplasms - surgery; Esophagectomy; Esophagus; Female; Follow-Up Studies; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gynecology; Hepatology; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Miscellaneous; Neoplasm Staging - methods; Positron-Emission Tomography - methods; Preoperative Care - methods; Proctology; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Reproducibility of Results; Sensitivity and Specificity; Surgery; Tomography, X-Ray Computed - methods; Tumors; Computed tomography; Endosonography; Positron emission tomography; Tumor staging; Esophageal cancer; Radionuclide study; Sonography; Endoscopic surgery; Radiodiagnosis; Endoscopic route; Staging; Endoscopic ultrasonography; Esophageal disease; Malignant tumor; Esophagus cancer; Treatment; Echography; Medical imagery; Digestive diseases; Computerized axial tomography; Preoperative; Comparative study; Cancer; Emission tomography
• ISSN: 0930-2794; 1432-2218; 1432-2218
• DOI: 10.1007/s00464-009-0783-x

Background Endoscopic ultrasonography (EUS) has been a useful method for the accurate staging of esophageal cancer. This study aimed to compare the diagnostic performance of EUS, positron emission tomography (PET), and computed tomography (CT) in the locoregional staging of resectable esophageal cancer. Methods A total of 109 patients with resectable esophageal cancer were prospectively enrolled and retrospectively reviewed for evaluation of preoperative EUS, PET, and CT. The sensitivity, specificity, and accuracy of tumor depth (T) staging and regional lymph nodal (N) staging for each test were compared with the postoperative histopathologic stage as the gold standard. Results The overall accuracy of EUS for T staging was 72%, and it was the only method for delineating the layers of the esophageal wall. The sensitivities for N staging were 42% for EUS, 49% for PET, and 35% for CT, and their specificities were, respectively, 91, 87, and 93%. The accuracy for N staging was 66% for EUS, 68% for PET, and 63% for CT, and it did not differ significantly across the three tests. Conclusions Preoperative EUS for the locoregional staging of esophageal cancer provides excellent T staging accuracy and similar accuracy for N staging compared with PET and CT. Especially in T staging, EUS could play an important role in the choice of candidates for esophageal cancer surgery.