EUS predictors of long-term survival in esophageal carcinoma

Background: EUS is the most accurate nonsurgical modality for the staging o f esophageal cancer, but the ability of EUS to predict outcomes or prognosi s is unclear. Patients were examined who had EUS performed for esophageal c ancer staging to determine which endosonographic features predict survival. Method: Data on 203 patients undergoing EUS for esophageal cancer staging w ere studied retrospectively. Median survival was calculated for each T-stag e and N-stage and according to the presence or absence of celiac axis (CAx) lymphadenopathy as determined by EUS, Kaplan-Meier survival curves were ge nerated for each stage and the log-rank test was used to test for significa nt differences in survival. Multivariate analysis was performed to test for the relative importance in predicting survival of the EUS stages, also con sidering age, gender, histology, and type of treatment. Results. Significant differences were found in the ability of EUS-determine d T-stage (p = 0.0005), N-stage (p < 0.0001), and presence of CAx nodes (p = 0.0049) to predict survival. Multivariate analysis showed N-stage to pred ict survival. Conclusions: Pretreatment EUS can predict survival in esophageal cancer bas ed on initial T-stage, N-stage, and the presence of CAx nodes, The presence of lymphadenopathy at EUS is an important predictor of survival, EUS shoul d be performed in all patients with esophageal cancer, not only for staging patients before therapy, but also as a valuable method of determining prog nosis.