Initial endoscopic description of esophageal squamous cell carcinomas

The aim of this study was to evaluate initial endoscopic practices at diagnosis of esophageal squamous cell carcinoma in comparison with current recommendations. We wanted to develop a standard model for the endoscopy report which could be used in routine practice.

From January 2000 to December 2002, 122 patients were hospitalized for esophageal squamous cell carcinoma. The initial endoscopic reports were reviewed retrospectively and compared with a model report established on the basis of current recommendations.

One hundred and nineteen reports were re-examined. The principal reason for performing the endoscopic examination was dysphagia in 73.9% of patients. Tumor measurements (height, upper and lower extremities) were recorded in 51.2%, 79% and 41% of reports, respectively. 14.4% of the analyzed reports concerned endoscopic procedures which were performed after a first endoscopic examination because the initial report provided an imprecise tumor description. Tissue samples taken during the initial endoscopy allowed a pathological diagnosis in 94.2% of patients. Lugol staining was performed in 2.5% of procedures.

Insufficiently rigorous reporting compromises the reliability of initial upper digestive endoscopic procedures. Application of a standardized model for routine practice would favor more complete reports, starting with the first procedure.