ENDOSCOPIC ULTRASONOGRAPHY FOR PREOPERATIVE STAGING OF ESOPHAGEAL-CARCINOMA

Endoscopic ultrasonography (EUS) is a relatively new diagnostic method to assess the extent and the depth of infiltration of esophageal carc inoma. Since October 1990, EUS was performed in 55 patients presenting with squamous-cell carcinoma of the esophagus, 40 of whom were operat ed on. The first 23 patients underwent EUS with an Olympus GF-2/EU-M2 echoendoscope with a 7.5-MHz transducer the last 32 patients underwent EUS with an Olympus GF-3/EU-M3 instrument with a 7.5-12-MHz echoprobe . In 22 patients, the procedure was not completed because of the impos sibility of passing through the neoplastic stenosis, The depth of infi ltration (T parameter) was correctly defined by EUS in 36 of 40 patien ts (90%) compared with 50% of computed tomography (CT). The 12-MHz ech oprobe yielded a global accuracy in staging T parameter of 94% compare d to 82% of 7.5-MHz transducer. The lymph-node involvement (N paramete r) was correctly classified by EUS in 20 of 23 patients (87%) compared with 39% by CT. EUS provides a high degree of accuracy in assessing t he T and the N parameter in the staging of squamous-cell esophageal ca rcinoma. The major problem of the instrument is still the frequent imp ossibility of passing through the neoplastic stenosis.