Radiologic assessment of resectability and prognosis in esophageal carcinoma

Utilizing double-contrast technique it is possible to detect the earliest malignant lesions of the esophagus even when the carcinoma is confined to the mucosa. In patients with carcinoma, it is also important to attempt to grade and classify the lesion in order to predict its resectability and prognosis. The resectability of a lesion is determined by the depth of invasion and by the presence or absence of lymph node metastases. The significant factors are the length of the lesion, its gross morphology, the character of its margins, and the depth of ulceration. Unfortunately, the depth of invasion is not necessarily directly related to the prognosis. In some carcinomas confined to the submucosa, lymph node metastases are already present, and these patients have a poor prognosis. The presence of lymph node metastases in early carcinoma can be suggested by the gross morphology of the lesion, its length, irregularity of the surface, and the presence of a complex lesion. Careful analysis of the radiographic features of the carcinoma can be valuable for the assessment of resectability and prognosis.