Radiological aspects of cancer of the esophagus

The role radiology plays in the study of cancer of the esophagus (CE) involves three different diagnostic steps: identification of CE; staging of CE and postoperative follow-up. This study comprises 117 cases of CE, all surgically confirmed: in 57/117 CE, resection of the neoplasm with subsequent reconstruction of the digestive tract proved possible; in the remaining 60/117 non-resectable CE, a Celestin prosthetic tube was positioned. The radiological diagnosis was correct in 92.3% of the cases, the diagnostic error (9/117: 7.7%) being mainly due to under-diagnoses (6/9) rather than false negatives (3/9). Conventional radiology provided satisfactory results in the staging of CE. Among the postoperative complications in the 57 resected patients, fistulae (13/57) and mediastinal abscesses (1/57) were early complications, whereas stenosis of the anastomosis (5/57) and neoplastic recurrences (3/57) were late complications. The possible role of diagnostic delay in the poor prognosis of CE, as well as its possible causes, are discussed in this paper.