Endoscopic Ultrasound in Squamous Cell Esophageal Cancer: From Staging to Strategy-A Narrative Review

Area of Science:

• Gastroenterology
• Oncology
• Medical Imaging

Background:

• Esophageal squamous cell carcinoma (ESCC) presents a significant global health burden, characterized by aggressive behavior and late diagnosis.
• Accurate locoregional staging is essential for effective ESCC treatment planning.
• Endoscopic ultrasound (EUS) is the leading imaging technique for evaluating tumor invasion depth and regional lymph node status in ESCC.

Purpose of the Study:

• To provide a comprehensive review of the utility of EUS in the management of ESCC.
• To discuss the strengths and limitations of EUS in staging and restaging ESCC.
• To highlight the integration of EUS with other diagnostic modalities and emerging techniques.

Main Methods:

• Narrative review of current literature on EUS in ESCC management.
• Discussion of EUS performance in differentiating early-stage disease and assessing response to neoadjuvant therapy.
• Exploration of multimodal imaging approaches (EUS, CT, PET) and novel EUS-based techniques.

Main Results:

• EUS is highly effective for assessing tumor depth and lymph node metastasis in ESCC.
• A multimodal approach integrating EUS with CT, PET, and histology enhances diagnostic precision.
• Emerging techniques like contrast-enhanced EUS and elastography show promise for improved assessment.

Conclusions:

• EUS is a cornerstone in the locoregional staging and management of ESCC.
• Integration of EUS with advanced imaging and personalized medicine strategies will further refine ESCC treatment.
• Ongoing innovation in EUS technology and therapeutic approaches is vital for improving patient outcomes in ESCC.