[The value of computed tomography for the staging of esophageal carcinoma]

64 patients were operated on for carcinoma of the oesophagus during a five-year period (1/83 to 1/88) at the Department of Surgery of the University of Cologne; 95.3% of these suffered from squamous cell carcinoma. A preoperative CT of the thorax was performed in 38 patients, 13 of whom underwent abdominothoracic surgery and 25 blunt oesophagus dissections. The CT and plain diagnostic results were compared retrospectively and postoperatively with the intraoperative or histological findings. Three of seven oesophageal carcinomas of up to 2 cm size were not identified by CT. Infiltration of adjacent mediastinal structures by T3 carcinomas was detected in 16 of 22 cases with 3 false positive findings. In blunt oesophagus dissection the preoperatively diagnosed lymph node status agreed with the histological findings in more than 80% of the cases; a limitation, however, was the fact that only those lymph nodes could be assessed that clung to the resectate. In contrast, agreement was seen in only 7 of 13 cases (with 6 false negative findings) after abdominothoracic resection of oesophageal carcinomas. On the whole, there was agreement between preoperative and histological staging according to the TNM classification (UICC = in 50% of the cases, whereas in almost 40% (n = 15) the size or extension of the tumour growth had been underestimated preoperatively. Hence, the value of CT for the preoperative staging of oesophageal carcinoma is restricted.