Computed tomography for oesophageal carcinoma: its value to the surgeon.
Between January 1988 and June 1991, 75 patients with carcinoma of the oesophagus or gastro-oesophageal junction were evaluated by computed tomography (CT). Fifty of these patients underwent operation, allowing 48 cases to have a detailed surgical and pathological verification of CT features. For thoracic oesophageal tumours the accuracy of CT was 59% for fat plane status, 86% for aortic contact, 81% for tracheobronchial tree compression and 66% for direct local invasion. CT was 69% accurate for identifying lymph nodes, of which only 38% contained metastatic deposits. For gastro-oesophageal junction tumours, CT was 74% accurate for fat plane status and 90% accurate for direct local invasion. Accuracy for detecting lymph node involvement was 63%, metastatic tumour being present in 91% of these nodes. By pathological staging, only 15% of all resections could be considered potentially curative. The value of CT was found to be in predicting a palliative or curative resection, and in warning the surgeon about possible infiltration of specific mediastinal or abdominal structures that would be encountered during operative dissection.
Consigliere
D
D
Department of Surgery, Tan Tock Seng Hospital, Singapore.
Chua
C L
CL
Hui
F
F
Yu
C S
CS
Low
C H
CH
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004943:Esophagogastric Junction / Q000000981:diagnostic imaging / Q000601:surgery; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed