Experience of endoscopic ultrasound in staging adenocarcinoma of the cardia

Aim: The introduction of endoscopic ultrasonography (EUS) has generally res ulted in a more accurate assessment of gastrointestinal regional tumour sta ge. Knowing the stage and the extent of oesophageal involvement is extremel y important as a guide to the choice of surgical approach in cardia cancer. The aim of this study was to evaluate the ability of EUS to accurately pre dict depth of tumour invasion (T), node involvement (N) and the tumour's in vasion length along the oesophagus. Material and methods: Thirty-five patients with adenocarcinoma of the cardi a were studied by EUS and the EUS pre-operative findings were compared with the pathology findings. Results: The overall accuracy in T staging was 55.2% (16/29 cases). The sen sitivity in evaluating T1, T2 and T3 classes was 80%, 38.5% and 70%, respec tively. The sensitivity was excellent in evaluating NO class (100%) (5 case s), but it fell to 66.7% in N1 cases. EUS correctly determined the extent o f oesophagus invasion in 75.9% (22/29) of cases; moreover, it had a very hi gh accuracy in distinguishing between tumours with an oesophageal invasion greater or lower than 2 cm (93.1%) (27/29 cases). Conclusion: EUS proved to be useful in pre-operative staging of cardia aden ocarcinoma and, in particular, in the pre-operative identification of the e xtent of oesophageal invasion.