title: Endoscopic ultrasonography is useful for monitoring the tumor response of neoadjuvant chemoradiation therapy in esophageal squamous cell carcinoma.
abstract: BACKGROUND
  Recently, neoadjuvant chemoradiation therapy (CRT) has been introduced for treatment of esophageal squamous cell carcinoma (ESCC). This study was performed to investigate the usefulness of endoscopic ultrasonography (EUS) in comparison with EUS findings before and after CRT, and histologic findings.
  
  
  METHODS
  There were 33 patients with potentially resectable ESCC who underwent neoadjuvant CRT. Preoperative EUS and histologic findings were compared. EUS criteria were established on the basis of low and high echoic regions. Resected specimens were examined by hematoxylin-eosin, azan, and cytokeratin immunohistochemical staining.
  
  
  RESULTS
  Azan and cytokeratin staining clearly delineated fibrous changes and residual tumor. Low echoic regions corresponded to residual tumor and high echoic spots corresponded to fibrosis. All 12 patients classified as grade 1 on EUS diagnosis had histologic grade 1 tumors. Nineteen of 21 cases that presented with high echo were grade 2 or 3. The prognosis according to EUS diagnosis was similar to the histologic effect.
  
  
  CONCLUSIONS
  Preoperative EUS findings reflected the histologic effect after neoadjuvant CRT. EUS is a useful tool to assess the effect for CRT and to predict the prognosis in ESCC patients.
authors.affiliation: Education Center for Doctors in Remote Islands and Rural Areas, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Japan. towaki@m2.kufm.kagoshima-u.ac.jp
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Owaki
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Uchicado
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kita
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Setoyama
authors.forename: Ken
authors.initials: K
authors.lastname: Sasaki
authors.forename: Toshihide
authors.initials: T
authors.lastname: Sakurai
authors.forename: Itaru
authors.initials: I
authors.lastname: Omoto
authors.forename: Mario
authors.initials: M
authors.lastname: Shimada
authors.forename: Fuminori
authors.initials: F
authors.lastname: Sakamoto
authors.forename: Heiji
authors.initials: H
authors.lastname: Yoshinaka
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ueno
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil