Abstract
Background. Dilation of malignant strictures in endoscopic ultrasound (EUS) staging of esophageal cancer is safe, but no data exists regarding the subsequent development of metastases. Aim. Compare the rates of metastases in esophageal cancer patients undergoing EUS staging who require esophageal dilation in order to pass the echoendoscope versus those who do not. Methods. We reviewed consecutive patients referred for EUS staging of esophageal cancer. We evaluated whether dilation was necessary in order to pass the echoendoscope, and for the subsequent development of metastases after EUS at various time intervals. Results. Among all patients with similar stage (locally advanced disease, defined as T3, N0, M0 or T1-3, N1, M0), there was no difference between the dilated and nondilated groups in the rates of metastases at 3 months (14% versus 10%), P = 1.0, 6 months (28% versus 20%), P = 0.69, 12 months (43% versus 40%), P = 1.0, or ever during a mean followup of 15 months (71% versus 55%), P = 0.48. Conclusions. Dilation of malignant strictures for EUS staging of esophageal cancer does not appear to lead to higher rates of distant metastases.
Highlights
Endoscopic ultrasound (EUS) is an important part of staging for esophageal cancer
There was no difference between the two groups with respect to age, sex, location of Squamous cell carcinoma Cervical esophagus stricture Thoracic esophagus stricture Gastroesophageal junction stricture Metastases present at time of endoscopic ultrasound (EUS) Locally advanced disease at time of EUS
EUS is an essential part of a comprehensive staging workup for esophageal cancer and, when used appropriately in conjunction with CT and/or positron emission tomography (PET) scan, is generally considered the most accurate tool for staging [31]
Summary
Endoscopic ultrasound (EUS) is an important part of staging for esophageal cancer It provides key information regarding local tumor invasion, locoregional, and celiac lymph node involvement. The safety of dilating malignant strictures for passage of an echoendoscope for esophageal cancer staging has been well established [2,3,4, 11]. Dilation of malignant strictures in endoscopic ultrasound (EUS) staging of esophageal cancer is safe, but no data exists regarding the subsequent development of metastases. Aim. Compare the rates of metastases in esophageal cancer patients undergoing EUS staging who require esophageal dilation in order to pass the echoendoscope versus those who do not. Dilation of malignant strictures for EUS staging of esophageal cancer does not appear to lead to higher rates of distant metastases
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