[Endoscopic ultrasound in preoperative TN staging of esophageal cancer. A comparative study between endosonography...

In 86 patients with histologically proven oesophageal carcinoma endoscopic ultrasonography (EUS) and computerised tomography (CT) were performed during TN-staging (UICC 1987). 44 patients were operated on and the histological findings were compared with the results of preoperative staging. The T-stage was correctly determined with EUS and CT in 35 (80%) and 24 (55%) patients, respectively. The accuracy of EUS was 75%, 71%, 91% and 67% in stages T1 to T4. The sensitivity of EUS in the diagnosis of lymph node metastases was 91%, that of CT 42%. The specificity of EUS and CT was 64% and 100%, respectively. The accuracy for pN staging (N0/N1) was 84% with EUS and 57% with CT. The presence of local lymph node metastases was closely correlated to the pT-stage (1 patient [14%] with pT1-, 5 patients [71%] with pT2-, 21 patients [95%] with pT3- and 6 patients [100%] with pT4-stage). In 12 out of 34 patients (28%) tumour induced stenosis prevented a complete oesophageal passage of the EUS probe. This fact, however, did not compromise TN-staging significantly. Our study demonstrates that EUS is an efficient method in the locoregional staging of oesophageal carcinoma. Especially in the early tumour stages T1 and T2 and in the demonstration of local lymph node metastases EUS is superior to CT.