title: Relevance of endoscopic ultrasound in the management of esophagus cancer therapy.
abstract: BACKGROUND
  The objective of this case series study by retrospective analysis was to determine the relevance of endoscopic ultrasound (EUS) in therapeutic decision esophageal cancer.
  
  
  METHODS
  Using medical records of the Department of Endoscopy of Santa Casa de São Paulo, we have collected data from 16 patients, in 4 years, diagnosed of esophageal cancer, and presented in the form of clinical cases to a specialist surgeon in esophageal cancer and a clinical oncologist, for therapeutic evaluation before and after the outcome of EUS.
  
  
  RESULTS
  Both of them choose non-resective and not curative methods (68.8% by surgeon vs. 87.5% oncologist) before EUS. The best treatment by the surgeon was chemotherapy and palliative radiotherapy associated (25%) and palliative endoscopic prostheses (25%), and by the oncologist, neoadjuvant chemotherapy and radiotherapy associated (56.2%). After EUS, the resective surgical treatment was the both choice in only 6.2% of cases, and the rest of 93.8%, non-resective. The surgeon choice was chemotherapy and palliative radiotherapy associated (44%), and oncologist choice was neoadjuvant chemotherapy and radiotherapy associated (44%). Analysis by the Chi-square method, comparing respective versus non-resective treatment, surgeon versus oncologist, with and without the EUS, obtained values of P = 0.39 and P = 0.46, respectively. The comparison between healing and non-healing treatment had the same P value. Regarding the change in behavior (resective vs. non-resective), there was a change of approach by the surgeon in 25% of cases (P = 0.17) and the oncologist moved conduct in 6.25% of cases. Comparing the changing of behavior among experts, the P value was 0.33. Despite evidence of behavior change after the EUS, the statistical point of view, the P value had no significant relevance. The main factor involved is probably due to a reduced number of sample cases. However, this is a pilot study, and is needed other with a larger number of cases.
  
  
  CONCLUSIONS
  The data obtained allow us to conclude that EUS proved to be an important test for the change in staging and therapeutic management of esophageal cancer.
authors.affiliation: Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Assef
authors.affiliation: Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Rossini
authors.affiliation: Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Rossini
authors.affiliation: Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: O
authors.initials: O
authors.lastname: Araki
authors.affiliation: Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: F
authors.initials: F
authors.lastname: Nakao
authors.affiliation: Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: J
authors.initials: J
authors.lastname: Silva
authors.affiliation: Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: W
authors.initials: W
authors.lastname: Duenas
authors.affiliation: Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: D
authors.initials: D
authors.lastname: Gagliardi
authors.affiliation: Santa Casa de São Paulo, São Paulo, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Fabricio