PROSPECTIVE-STUDY ON THE VALUE OF ENDOSONOGRAPHIC FOLLOW-UP AFTER SURGERY FOR ESOPHAGEAL-CARCINOMA

Background: Half of the patients who undergo surgery for cancer of the esophagus or gastric cardia present with recurrent disease within 2 y ears after the operation. We investigated the value of endosonography for the early detection of recurrent disease. Methods: Forty-three pat ients entered a follow-up protocol in which endosonography was perform ed every 6 months within the first 2 years after resection. Results: D uring 16 of a total of 66 examinations, suspicious abnormalities were found. In three patients free fluid was seen, but recurrence could not be confirmed during follow-up. In eight patients suspicious lymph nod es were seen; six died within 6 months, one was alive with a proven re currence at 6 months, and one was alive without recurrence at 22 month s. In five patients focal wall-thickening or a mass was seen; three di ed within 6 months, and two were alive with a proven recurrence at 2 a nd 5 months. After exclusion of free fluid, the positive predictive va lue of abnormalities on endoscopic ultrasonography (EUS) was 92%. Conc lusions: Endosonography, performed at 6-month intervals after resectio n of cancer of the esophagus or gastric cardia, is accurate in the ear ly detection of locoregional recurrent disease. Two thirds of the pati ents were still without symptoms when the recurrence was found.