Relation between endoscopic ultrasound findings and outcome of patients with tumors of the esophagus or esophagogastric junction

Abstract

Background: Endoscopic ultrasound (EUS) is considered to be the best staging technique for cancer of the esophagus or the esophagogastric junction. This study evaluates the relation between preoperative EUS staging results of these tumors and survival. It also examines how EUS staging predicts resectability. Methods: Survival data of 86 patients who underwent EUS for staging of tumors of the esophagus or esophagogastric junction were analyzed. Most patients (78 of 86) were treated surgically (73 resections, 5 bypasses). Eight patients did not undergo surgery. Results: Survival of patients was significantly related to EUS T staging (log rank test: p = 0.05), EUS N staging ( p = 0.02), detection of celiac lymph node metastasis ( p = 0.0027), and the presence of stenosis ( p = 0.02). Also, the endosonographic AJCC classification was significantly related to survival ( p = 0.0012). Total accuracy for T staging amounted to 59%. Accuracy for recognition of transmural growth was 82%. There was a good association between endosonographic findings (EUS stage II, absence of lymph nodes) and the possibility of complete resection. Incomplete resection was less well predicted. Conclusion: Survival of patients with tumors of the esophagus or esophagogastric junction is strongly related to EUS TNM staging results. Tumor resectability is related to endosonographic findings. However, more advanced EUS findings do not necessarily predict unresectability. (Gastrointestinal Endosc 1997;45:381-6.)