Comparative study between endoscopic ultrasonography and positron emission tomography-computed tomography in staging patients with esophageal squamous cell carcinoma
Journal
Diseases of the Esophagus
Journal Volume
25
Journal Issue
1
Pages
40-47
Date Issued
2012
Author(s)
Yen T.-J.
Chung C.-S.
Abstract
Treatment strategy of esophageal cancer mainly depends on accurate staging. At present, no single ideal staging modality is superior to another in preoperative tumor-node-metastasis (TNM) staging of patients with esophageal cancer. We aimed to investigate the efficacy of endoscopic ultrasonography (EUS) and positron emission tomography-computed tomography (PET-CT) for staging of esophageal cancer. We retrospectively studied 118 consecutive patients with esophageal squamous cell carcinoma who underwent esophagectomy with or without neoadjuvant chemoradiotherapy (CRT) over a near 3-year period between January 2005 and November 2008 at a tertiary hospital in Taiwan. Patients were separated into two groups: without neoadjuvant CRT (group 1, n= 28) and with CRT (group 2, n= 90). Medical records of demographic data and reports of EUS and PET-CT of patients before surgery were reviewed. A database of clinical staging by EUS and PET-CT was compared with one of pathological staging. The accuracies of T staging by EUS in groups 1 and 2 were 85.2% and 34.9%. The accuracies of N staging by EUS in groups 1 and 2 were 55.6% and 39.8%. The accuracies of T and N staging by means of PET-CT scan were 100% and 54.5% in group 1, and were 69.4% and 86.1% in group 2, respectively. In group 2, 38 of 90 patients (42.2%) achieved pathologic complete remission. Among them, two of 34 (5.9%) and 12 of 17 (70.6%) patients were identified as tumor-free by post-CRT EUS and PET-CT, respectively. EUS is useful for initial staging of esophageal cancer. PET-CT is a more reliable modality for monitoring treatment response and restaging. Furthermore, the accuracy of PET-CT with regard to N staging is higher in patients who have undergone CRT than those who have not. ? 2011 the Authors. Journal compilation ? 2011, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.
SDGs
Other Subjects
cetuximab; cisplatin; fluorouracil; folinic acid; paclitaxel; adult; aged; article; cancer staging; computer assisted emission tomography; controlled study; diagnostic accuracy; endoscopic echography; esophageal squamous cell carcinoma; esophagus resection; female; human; major clinical study; male; priority journal; sensitivity and specificity; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Chemoradiotherapy, Adjuvant; Endosonography; Esophageal Neoplasms; Esophagectomy; Female; Humans; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Positron-Emission Tomography and Computed Tomography; Retrospective Studies; Sensitivity and Specificity; Treatment Outcome
Type
journal article