Résumé
L’échoendoscopie est une technique d’examen permettant de réaliser le bilan d’extension des cancers de l’œsophage et de l’estomac et vient en concurrence ou en complément du PET scan.
Ses performances sont connues et permettent de prédire le stade T et N dans 85 et 75 % des cas respectivement.
Son utilité a été peu étudiée pour apprécier la réponse aux traitements non chirurgicaux.
Cependant, d’après les données disponibles, on peut actuellement retenir que: les performances diagnostiques de cette exploration chutent après radiothérapie en raison des phénomènes inflammatoires et fibrosants; seule une restitutionad integrum de la paroi œsophagienne permet de conclure à une réponse complète; la réduction tumorale peut être évaluée par la mesure des surfaces tumorales sur des coupes transversales et s’associe à un meilleur pronostic.
La recherche d’une récidive peut être réalisée à l’aide de cette exploration en s’aidant de la ponction à l’aiguille fine.
Summary
Endoscopic ultrasonography is an imaging technique which allows an optimal staging of esophageal and gastric cancers and is currently competing or completing PET scan in this indication.
Its diagnostic performances are currently well known and lead to T and N staging in 85% and 75% of cases, respectively.
Its effectiveness has been poorly studied in assessing tumour response to non surgical treatments.
However, according to available studies, it can be remembered that: diagnostic performance falls down after radiation therapy due to inflammatory and fibrosing changes; only restitutionad integrum means complete response; tumour reduction can be assessed by measuring tumour area on cross-sectional images and is associated with better prognosis.
Looking for local recurrence can be performed with this technique in association with fine needle aspiration.
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Burtin, P. Echoendoscopie et cancer de l’œsophage et de l’estomac. Acta Endosc 38, 1–5 (2008). https://doi.org/10.1007/BF02961968
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DOI: https://doi.org/10.1007/BF02961968
Mots-clés
- bilan d’extension
- chimiothérapie
- échoendoscopie
- PET-scan
- radiothérapie
- tumeur gastrique
- tumeur œsophagienne