Objective: To evaluate the value of different methods in preoperative staging of esophageal carcinoma.
Method: Thirty-six patients undergoing resection of esophageal carcinoma were examined with endoesophageal ultrasonography (EU) before operation. Eight of 36 patients could not be evaluated because of severe esophageal stenosis. Computerized tomography (CT) was performed in 21 patients. Comparison was made between stagings based on EU, CT as well as the conventional clinical staging system, respectively with surgical-pathological staging after resection.
Result: The accuracy of conventional clinical staging for esophageal cancer was only 36%. The accuracy of CT in T, N and pTNM staging was 38.1%, 57.1% and 47.6% respectively. For EU, the figures were 77.8%, 72.2% and 72.2%, and were improved to be 85.7%, 78.6% and 83.1% when untraversable patients were excluded.
Conclusion: While conventional clinical staging system lacks accuracy in evaluating esophageal carcinoma, CT makes only moderate improvement. Based on direct morphological examination of lesions, EU is highly accurate in preoperative staging of esophageal carcinoma, especially in evaluating the extent of luminal wall invasion and regional lymph node involvement. Therefore, EU is of critical value in the therapeutic selection for esophageal carcinoma.