[Ultrasound of hypopharyngeal and oesophageal cancer: possibilities and limitations to staging and planning of therapy].
Sonographic examination of the hypopharynx and the extrathoracic oesophagus can be difficult. Therefore, most surgeons prefer to utilise CT or MRI scanning. Surgery is planned on the basis of endoscopic findings combined with radiologic information. The aim of the present prospective study was to demonstrate that the combination of ultrasonography and endoscopy provides a sufficient basis for the planning of surgical interventions in patients suffering from hypopharyngeal cancer or cancer of the proximal oesophagus. In 10 patients with squamous cell carcinoma of the hypopharynx/proximal oesophagus (8T4, 2T2) and 2 patients with a T4 squamous cell carcinoma of the larynx, both preoperative CT and ultrasound were performed and compared with the extent of the tumour seen during endoscopy. With ultrasound, the T4 tumours of the hypopharynx were recognized well as opposed to the T2 tumours which were not detected. The CT results were similar. An infiltration of the proximal oesophagus was seen with both imaging techniques in all affected patients. In contrast to CT, intralaryngeal tumour spread was not seen with ultrasound as long as the laryngeal skeleton was intact. The retropharyngeal region could also not be examined by ultrasound. Nevertheless, these results show that in all patients included in this study the extent of the tumour could have been estimated correctly by using ultrasound plus endoscopic examination alone. The reliable examination of this anatomically difficult region, however, requires examiner experience.
Jecker
P
P
Hals-Nasen-Ohrenklinik der Johannes-Gutenberg-Universität Mainz. jecker@hno.klinik.uni-mainz.de
Schuon
R
R
Hlawatsch
A
A
D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography