Dynamic computed tomography assessment of local extent and resectability of esophageal carcinoma

The aim of this study was to define the usefulness of dynamic computed tomography in the preoperative assessment of esophageal cancer. CT scanning was performed in 93 patients with proven carcinoma of the esophagus. All results of CT were compared with surgical and pathologic findings. The analysis used the AJCC classification adapted to the needs of CT. The local extent of the primary tumour (T-stage) and its resectability were assessed and compared for different locations of the tumour. The overall accuracy of CT in tumour staging was 68.8%, 20.4% cases were overstaged and 10.4% were understaged. The highest sensitivity of CT has been obtained in estimation of tumours involving adjacent organs--T4--(86.5%) and the lowest for T3 (37.5%). Infiltration of surrounding vital structures could be proven with the positive predictive value of 69.7% and the negative predictive value of 97.3%. The efficiency of CT estimation for local tumour extent did not differ according to the tumour location. A high agreement (81.7%) was noted between CT results and intraoperative findings in assessing resectability.