FIBEROPTIC BRONCHOSCOPY IN THE EVALUATION OF NEWLY-DIAGNOSED ESOPHAGEAL-CARCINOMA

To determine the diagnostic utility of fiberoptic bronchoscopy (FB) in the evaluation of patients with newly diagnosed esophageal carcinoma (EC) and whether FB findings impact therapy and survival, we retrospec tively reviewed 2,832 FB records (1984 through 1992). Twenty-two cases were identified in which FB was performed to evaluate pulmonary invol vement in patients with newly diagnosed EC. Two cases were eliminated due to data unavailability, Seventeen of 20 patients had no pulmonary symtoms and most of them (15/17) had normal chest radiographs, All thr ee patients with pulmonary symptoms (cough, hemoptysis, dyspnea) had s ignificant radiographic abnormalities, In the asymptomatic group, FB f indings were normal in nine, showed extrinsic compression of the trach ea and/or bronchi in seven, and demonstrated a submcosal tumor nodule in one, The pathologic diagnosis of malignant airway involvement was n ot made in any asymptomatic patient, In the three symptomatic patients , extensive endobronchial abnormalities were present, Therapy with sur gery, radiation, and/or chemotherapy did not differ among patients wit h extrinsic compression compared to patients with normal FB, Average s urvival in the patients with normal endobronchial anatomy was 20.5 mon ths, in the group with extrinsic compression 12.2 months, and in the g roup with marked endobronchial abnormalities, less than 1 month, Stati stical analysis of our findings suggest that FB is a low-yield procedu re in the evaluation of patients with EC unless pulmonary symptoms of cough and/or hemoptysis or chest radiographic abnormalities are presen t.