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A Study Comparing Endoscopic Ultrasound (EUS) and Computed Tomography (CT) in Staging Oesophageal Cancer and their Role in Clinical Decision Making

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Abstract

Background and Aim

Computed tomography (CT) and endoscopic ultrasound (EUS) are part of the regular preoperative staging protocol in oesophageal cancer. At present, EUS is increasingly being used for preoperative locoregional staging of oesophageal cancer. The aim of this study is to compare EUS and CT findings and their role in clinical decision making.

Methods

The CT staging of 30 patients with oesophageal carcinoma was compared with EUS. This is a single centre-based study, and the EUS was carried out by a single operator.

Results

The mean age was 58.2 years. On EUS, one (3.3%), five (16.7%), 16(53.3%) and eight (26.7%) patients had T1, T2, T3 and T4 tumours, respectively, compared with CT which showed 12(40%), nine (30%) and seven (23.3%) patients with T2, T3 and T4 tumours. On CT, two (6.7%) were shown as no tumour (T0). EUS revealed lymph node involvement in 25 (83.3%) patients compared with CT which indicated lymph node involvement in seven (23.3%) patients. On EUS, coeliac node involvement was shown in four (13.3%) patients (M1). The TNM staging of CT and EUS were comparable in nine (30%) patients. EUS staging revealed a more advanced stage of oesophageal cancer in 17 (56.7%) patients. Preoperative EUS staging changed the decision of management in 15 (50%) patients (P < 0.005).

Conclusions

EUS staging revealed a more advanced stage of cancer in the majority of patients. It appears to be far more superior in detecting lymph node involvement compared with CT. Therefore, EUS may have a significant impact on deciding the treatment modality of a patient with oesophageal carcinoma.

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Acknowledgement

The authors wish to thank Professor Chandu de Silva (Professor of pathology), Professor Preethika Angunawala, Professor Dilani Lokuhetti, Dr. Niranthi Perera for the histopathology reports.

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Authors and Affiliations

  1. University Surgical Unit, National Hospital of Sri Lanka, 28/1, Ishwari road, Colombo, 06, Sri Lanka

    Duminda Subasinghe & Dharmabandhu Nandadeva Samarasekera

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  1. Duminda Subasinghe
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  2. Dharmabandhu Nandadeva Samarasekera
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Correspondence to Dharmabandhu Nandadeva Samarasekera.

Additional information

Duminda Subasinghe and Dharmabandhu N. Samarasekera were involved in planning, data collection, analysis of data and writing the manuscript.

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Subasinghe, D., Samarasekera, D.N. A Study Comparing Endoscopic Ultrasound (EUS) and Computed Tomography (CT) in Staging Oesophageal Cancer and their Role in Clinical Decision Making. J Gastrointest Canc 41, 38–42 (2010). https://doi.org/10.1007/s12029-009-9105-8

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  • DOI: https://doi.org/10.1007/s12029-009-9105-8

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