Does Preoperative EUS Staging Have Influence on the 5-Year Survival Rate of Esophageal Cancer?

Abstract

Introduction: To analyze the value of endoscopic ultrasound in the staging work-up of esophageal cancer. Methods: Retrograde chart review was performed to collect the clinical data for patients diagnosed with esophageal cancer. For survival analysis, those who were diagnosed before 2009 were included. Data variables including demographics, comorbidities, imaging (CT, PET, EGD, EUS), staging, insurance status, and survival duration were included. Early stages include stage1a to 2b; late stages include stage III and IV. Correlation; cross tabulation; linear regression and T-TEST analysis were performed using SPSS software. Results: Fifty-five patients were included in the study; 74.1% (43) were white, 5.2% (3) black, 10.3% Hispanic, and 11% mixed races. Regarding gender, 69% were male and 24% female. Twenty-eight patients had preop EUS (52%), 25 (48%) didn’t have EUS. Overall mean survival duration was 602 days. The mean survival duration was 631 and 571 days in EUS and non-EUS groups, respectively, with no statistical significance (p=0.08). Nineteen patients were in the early stage of the cancer and 34 patients in the late stages. Comparing stage for stage, there was no difference in the survival for patients who had preoperative EUS vs non-EUS. There was also no statistical difference in the survival duration between squamous vs adenocarcinoma (p=0.5). There was a positive correlation between the albumin level, BMI, and the 5-year survival and negative correlation between the existence of comorbidities and the 5-year survival with no difference between the EUS and non-EUS group. Conclusion: Our study suggests that the role of preop EUS for the staging work-up of esophageal cancer may be limited. We specifically found that there is no statistical significance in the 5-year survival between groups who had EUS as a staging work-up and those who did not have EUS.