STAGING OF ESOPHAGEAL-CARCINOMA BY ENDOSCOPIC ULTRASOUND - PRELIMINARY EXPERIENCE

Background: Endoscopic ultrasound (EUS) is a relatively recent imaging modality that is capable of visualizing oesophageal tissue layers and para-oesophageal structures. Current pre-operative staging of oesopha geal cancer is less than satisfactory, and a modality which may improv e pre-operative staging, thus allowing a more rational approach to cho ice of treatment, may be a welcome addition to current techniques. The purpose of the present study was to evaluate the accuracy of EUS in t he staging of oesophageal carcinoma in a consecutive cohort of patient s. Methods: Forty-three patients with oesophageal cancer were prospect ively staged with EUS using the radial scanning Olympus EUM-3 echo-end oscope. Tn the 28 patients who underwent surgery EUS staging was corre lated with operative and histological findings to evaluate the EUS acc uracy rate of assessing tumour depth (T stage), and the presence of no dal involvement (N stage) using internationally accepted TNM staging c riteria. Results: Endoscopic ultrasound accuracy rates for overall T-s taging was 61% whereas that of N-staging was 75%. The overall TNM path ological staging was 75% accurate by EUS. Conclusions: Compared to pub lished literature figures for oesophageal staging by computed tomograp hy scanning (39-54%) these results demonstrate that EUS has a reasonab le accuracy rate for staging. Endoscopic ultrasound may prove to be a useful additional modality in the management of oesophageal cancer.