Preoperative evaluation of oesophageal adenocarcinoma.
The preoperative evaluation of oesophageal adenocarcinoma involves endoscopic ultrasound (EUS), computed tomography (CT), and positron emission tomography (PET). With routine Barrett's oesophagus surveillance, superficial cancers are often identified. EUS, CT and PET have a limited role in the staging of superficial tumours. Standard EUS has limited accuracy, but high frequency ultrasound miniprobes are valuable for assessing tumour stage in superficial tumours. However, the best method for determining depth of invasion, and thereby stage of disease, is endoscopic mucosal resection. In contrast, in advanced oesophageal cancers, a multi-modality approach is crucial. Accurate tumour staging is very important since the treatment of advanced cancers involves a combination of chemotherapy, radiation, and surgery. EUS is very useful for staging of the tumour and nodes. High frequency ultrasound miniprobes provide the ability to perform staging when the lesion is obstructing the oesophageal lumen. CT and PET provide valuable information regarding node and metastasis staging.
Division of Digestive & Liver Diseases, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA. Electronic address: lg2455@columbia.edu.
Lauren G
LG
Khanna
Division of Digestive & Liver Diseases, Columbia University Medical Center, 161 Fort Washington Avenue, Herbert Irving Pavilion 13, New York, NY 10032, USA. Electronic address: fgg2109@columbia.edu.
Frank G
FG
Gress
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000209:etiology; D001471:Barrett Esophagus / Q000150:complications* / Q000473:pathology; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
Adenocarcinoma; Computed tomography; Endoscopic mucosal resection; Endoscopic ultrasound; Miniprobe; Oesophageal cancer; Positron emission tomography; Staging