Computed tomography for staging of oesophageal cancer

Background and Aims: Computed tomography (CT) is still widely used in the s taging of patients with carcinoma of the oesophagus. The aim of the study w as to evaluate the dianostic accuracy of CT in a series of patients with ca rcinoma of the oesophagus or the cardia. Results were compared with finding s at surgery or autopsy. Material and Methods: 47 consecutive patients of whom 30 underwent operatio n while 17 patients were not candidates for surgery due to advanced disease . Results: Demonstration of tumour invasion on CT in 30 patients who underwen t operation had an accuracy of 63 %, a nosographic sensitivity of 10 % and a specificity of 90 %. Diagnosis of metastases to abdominal lymph nodes had an accuracy of 57 %, and a nosographic sensitivity and specificity of resp ectively 37 % and 90 %. The assessment of tumour invasion and metastases to lymph nodes in patients not candidates for surgery was expectedly more acc urate (100 and 67 %, respectively, in nine autopsies). Conclusion: CT may provide valuable information in pretherapeutic staging o f oesophageal cancer by identifying patients with advanced disease, who are not candidates for surgery. In patients without signs of dissemination on CT additional information may be obtained from endoscopic ultrasonography a nd laparoscopy.