Oesophageal carcinoma: new therapeutic strategies due to accurate staging by modern diagnostic methods

Introduction: Since the tumour stage has significant prognostic and therape utic implications, accurate preoperative staging is decisive. Algorithm for diagnostic studies: Flexible endoscopy of the oesophagus with biopsies is the first diagnostic step in patients with signs of oesophagea l cancer and allows assessment of (1) tumour localisation, (2) tumour size, (3) grade of stricture, (4) type of histology and (5) nra cellular grading . Thereafter, CT scan of the chest and upper abdomen is performed to assess the provisional TNM stage. The local TN stage is verified in operable pati ents by endosonography and additionally by bronchoscopy if the tumour is lo cated in the upper half of the oesophagus. The M stage can be preoperativel y verified by laparoscopy. Conclusion: Modern diagnostic methods yield accurate staging, which makes i t possible to optimise selection of the most appropriate therapeutic strate gy.