Accuracy and influence factors of preoperative clinical staging for T2 esophageal cancer by endoscopic ultrasound_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Jun , CAO Haixia , ZHANG Wei , HUA Xionghuai , MA Haibo ,  LI Yin

Henan Tumor Hospital, Zhengzhou, 450008, P.R.China;

Corresponding author：

LI Yin, Email: liyin825@aliyun.com

Keywords：

Endoscopic ultrasonography; T2 esophageal carcinoma; preoperative T staging

DOI：

10.7507/1007-4848.201611042

Video：

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Objective To evaluate the accuracy and investigate the influence factors of preoperative T staging by endoscopic ultrasonography (EUS) in patients with postoperative pathological stage of T2 esophageal carcinoma (EC). Methods A total of 206 patients with EC underwent EUS and curative operation in Henan Tumor Hospital from March 2015 to January 2016 were enrolled, among whom 81 patients were identified with pathological stage of T2 EC followed by esophageal resection without induction therapy. There were 59 males and 22 females, with a mean age of 63.9 years and meadian age of 63.0 years. We reviewed the medical records of the 81 patients and compared EUS findings with histopathologic results according to clinicopathologic factors. Results The overall accuracy of EUS for evaluating staging of T2 EC was 61.7% (50/81), while 38.3% (31/81) were overstaged by EUS. Accuracy differed between the accurate staging group and over staging group (P=0.023). There was no significant difference in sex, age, tumor location and shape, histologic type, tumor differentiation or lymph node metastasis between two groups. Conclusion EUS is highly overstaged in the diagnosis of postoperative pathological stage of T2 EC. Higher postoperative pathological TNM stage appears to be a factor of EUS overstaging in patients with postoperative pathological stage of T2 EC.

Citation： ZHANG Jun, CAO Haixia, ZHANG Wei, HUA Xionghuai, MA Haibo, LI Yin. Accuracy and influence factors of preoperative clinical staging for T2 esophageal cancer by endoscopic ultrasound. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(10): 760-763. doi: 10.7507/1007-4848.201611042 Copy

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11.	Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. Lancet Oncol, 2011,12(7):681-692.
12.	Allum WH, Blazeby JM, Griffin SM, et al. Guidelines for the management of oesophageal and gastric cancer. Gut, 2010, 60(11):1449-1472.
13.	Puli SR. Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review. World J Gastroenterol, 2008,14(10):1479-1490.
14.	Kutup A, Vashist YK, Groth S, et al. Endoscopic ultrasound staging in gastric cancer: Does it help management decisions in the era of neoadjuvant treatment? Endoscopy, 2012, 44(6):572-576.
15.	Jung JI, Kim GH, IH, et al. Clinicopathologic factors influencing the accuracy of EUS for superficial esophageal carcinoma. World J Gastroenterol, 2014, 20(20):6322-6328.
16.	Sandha GS, Severin D, Postema E, et al. Is positron emission tomography useful in locoregional staging of esophageal cancer? Results of a multidisciplinary initiative comparing CT, positron emission tomography, and EUS. Gastrointest Endosc, 2008, 67(3):402-409.

1. 赫捷, 赵平, 陈万, 主编. 2012 中国肿瘤登记年报. 北京: 军事医学科学出版社, 2012. 100-101.
2. Wang GQ, Jiao GG, Chang FB, et al. Long-term results of operation for 420 patients with early squamous cell esophageal carcinoma discovered by screening. Ann Thorac Surg, 2004,77(5):1740-1744.
3. Byrne MF, Jowell PS. Gastrointestinal imaging: Endoscopic ultrasound. Gastroenterology, 2002,122(6):1631-1648.
4. Kelly S, Harris KM, Berry E, et al. A systematic review of the staging performance of endoscopic ultrasound in gastro-oesophageal carcinoma. Gut, 2001, 49(4):534-539.
5. 施宏, 陈素玉, 谢招飞, 等. 超声内镜及 CT 检查对食管癌术前 TN 分期的价值. 中华消化内镜杂志, 2008,25(5):233-235.0.
6. 曾安祥, 崔毅, 汪福群,等. 超声内镜检查对食管癌术前 TN 分期的临床价值. 临床外科杂志, 2015,23(4):308-310.0.
7. Tekola BD, Sauer BG, Wang AY, et al. Accuracy of endoscopic ultrasound in the diagnosis of T2N0 esophageal cancer. J Gastrointest Cancer, 2014,45(3):342-346.
8. Choi J, Kim SG, Kim JS, et al. Comparison of endoscopic ultrasonography (EUS), positron emission tomography (PET), and computed tomography (CT) in the preoperative locoregional staging of resectable esophageal cancer. Surg Endosc, 2010,24(6):1380-1386.
9. Meister T, Heinzow HS, Osterkamp R, et al. Miniprobe endoscopic ultrasound accurately stages esophageal cancer and guides therapeutic decisions in the era of neoadjuvant therapy: results of a multicenter cohort analysis. Surg Endosc, 2013,27(8):2813-2819.
10. Misra S, Choi M, Livingstone AS, et al. The role of endoscopic ultrasound in assessing tumor response and staging after neoadjuvant chemotherapy for esophageal cancer. Surg Endosc, 2012,26(2):518-522.
11. Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. Lancet Oncol, 2011,12(7):681-692.
12. Allum WH, Blazeby JM, Griffin SM, et al. Guidelines for the management of oesophageal and gastric cancer. Gut, 2010, 60(11):1449-1472.
13. Puli SR. Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review. World J Gastroenterol, 2008,14(10):1479-1490.
14. Kutup A, Vashist YK, Groth S, et al. Endoscopic ultrasound staging in gastric cancer: Does it help management decisions in the era of neoadjuvant treatment? Endoscopy, 2012, 44(6):572-576.
15. Jung JI, Kim GH, IH, et al. Clinicopathologic factors influencing the accuracy of EUS for superficial esophageal carcinoma. World J Gastroenterol, 2014, 20(20):6322-6328.
16. Sandha GS, Severin D, Postema E, et al. Is positron emission tomography useful in locoregional staging of esophageal cancer? Results of a multidisciplinary initiative comparing CT, positron emission tomography, and EUS. Gastrointest Endosc, 2008, 67(3):402-409.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Accuracy and influence factors of preoperative clinical staging for T2 esophageal cancer by endoscopic ultrasound

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