ENDOSCOPIC ULTRASOUND FOR STAGING ESOPHAGEAL CANCER, WITH OR WITHOUT DILATION, IS CLINICALLY IMPORTANT AND SAFE

Background: To fully evaluate patients with esophageal cancer by endos copic ultrasonography (EUS), the transducer must pass through the enti re tumor to the cardia to scan the celiac axis. Dilation may be necess ary. Published information suggests that dilation with EUS carries a s izeable risk. Methods: In order to assess the complication rate associ ated with dilation prior to EUS in patients with esophageal cancer and the clinical significance of dilation for complete EUS staging, we re viewed the records of all patients who had undergone EUS for esophagea l cancer. Results: Sixty-three patients underwent EUS staging of esoph ageal cancer. Thirty-nine (62%) had lesions through which the EUS scop e was passable (Group I). Ten (16%) patients (Group II) had lesions th rough which an EUS scope (diameter 13 mm) was unable to pass even afte r dilation. Fourteen patients (22%) had lesions that were dilated to a llow passage of the EUS scope (Group III). All patients in Groups II a nd III had confirmation of EUS staging by CT and/or surgery. In Group II, five patients had tumors defined as T4 (50%) and five as T3 (50%). In Group III, nine (64%) had T4 tumors, four (29%) had T3, and one (7 .7%) had T2. No complications were encountered in any group. Conclusio n: EUS, either alone or after dilation, is a safe procedure and the co mplete EUS examination with celiac node visualization adds prognostica lly significant information.