Endosonography for Cancer of the Esophagus and Cardia: Is it Worthwhile?

N. K. Altorki *
H. Snady **
D. B. Skinner *

* The New York Hospital-Cornell Medical Center, 525 East 68th Street, New York, NY 10021
** Mount Sinai Medical Center, One Gustave Levy Plaza, New York, NY 10128, USA

SUMMARY. The introduction of endoscopic ultrasonography has generally resulted in a more accurate assessment of malignant mural penetration and nodal involvement. We evaluated the role of endoscopic ultrasonography in the clinical staging of 55 patients with carcinoma of the esophagus and cardia, who underwent esophagectomy with complete mediastinal and abdominal lymphadenectomy.

The positive predictive value for T1, T2 and T3 tumors were 100%, 31% and 92% respectively. For N0 and N1 disease the positive predictive value was 44% and 79% respectively. Endoscopic ultrasonography correctly predicted tumor-lymph node-metastases stage in 62% of patients.

The data suggest that, although endoscopic ultrasonography is a reasonable modality to evaluate the primary tumor, its ability to predict nodal status is operator-dependent and may result in overstaging of patients without nodal metastases.

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