Endoscopic ultrasound with conventional probe and miniprobe in preoperative staging of esophageal cancer.
BACKGROUND
Using an endoscopic ultrasound (EUS) miniprobe, even highly stenotic esophageal cancers precluding the passage of a conventional probe can be examined without prior dilatation.


OBJECTIVE
To assess: (1) staging accuracy of conventional EUS probe and miniprobe, (2) variables influencing staging accuracy, (3) endoscopic features predicting tumor stage.


METHODS
Ninety-seven consecutive patients with esophageal cancer undergoing complete surgical resection were included. Preoperative EUS was performed using a conventional probe in nonstenotic tumors and a miniprobe in stenotic tumors. Accuracy of EUS for T and N stages was compared to pathohistological staging.


RESULTS
Overall EUS staging accuracy was 73.2% for T stage and 74.2% for N stage. It was similar for the miniprobe used in stenotic tumors vs the conventional probe used in nonstenotic tumors. Based on EUS, 84.5% of the patients would have been assigned to the appropriate therapy protocol (primary surgery vs neoadjuvant therapy). Endoscopic tumor features had no influence on staging accuracy. Tumor length >5 cm predicted advanced T and nodal positive stages.


CONCLUSIONS
The miniprobe allows adequate EUS staging of stenotic esophageal tumors precluding the passage of a conventional probe. Therefore, dilatation therapy of stenotic cancers to conduct conventional EUS should be avoided.
Mennigen
Rudolf
R
Department of General Surgery, University of Münster, Münster, Germany. rudolf.mennigen@uni-muenster.de
Tuebergen
Dirk
D
Koehler
Gabriele
G
Sauerland
Cristina
C
Senninger
Norbert
N
Bruewer
Matthias
M
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D003251:Constriction, Pathologic; D019160:Endosonography / Q000295:instrumentation / Q000379:methods*; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery; D004943:Esophagogastric Junction; D004947:Esophagus / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged