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Clin Radiol. 2014 Sep;69(9):959-64. doi: 10.1016/j.crad.2014.04.023. Epub 2014 Jun 7.

N-staging of oesophageal and junctional carcinoma: is there still a role for EUS in patients staged N0 at PET/CT?

Author information

1
Department of Radiology, University Hospital of Wales, Cardiff, UK. Electronic address: kfoley@doctors.org.uk.
2
Department of Surgery, University Hospital of Wales, Cardiff, UK.
3
Department of Wales Research & Diagnostic Positron Emission Tomography Imaging Centre (PETIC), University Hospital of Wales, Cardiff, UK.
4
Department of Radiology, University Hospital of Wales, Cardiff, UK.

Abstract

AIM:

To assess whether separate endoscopic ultrasound (EUS) lymph node (N)-staging is still of prognostic value in those staged node negative (N0) at combined positron-emission tomography/computed tomography (PET/CT) in patients with oesophageal cancer (OC).

MATERIALS AND METHODS:

One hundred and seventeen consecutive patients [median age 67 years; 88 male; 98 cases of adenocarcinoma, 19 cases of squamous cell carcinoma (SCC)] staged as N0 at PET/CT underwent EUS to record tumour (T)- and N-stage. The patients were subsequently separated into two groups: EUS N0 (n = 78) and EUS N+ (n = 39). Survival analysis using Kaplan-Meier and Cox's proportional hazard methods was performed. Primary outcome was overall survival from diagnosis.

RESULTS:

EUS N-stage and EUS N0 versus EUS N+ (p = 0.005 and p = 0.001, respectively) were found to be significantly and independently associated with survival in two models of multivariate analysis, in patients staged N0 at PET/CT. EUS T-stage was significantly associated with survival on univariate analysis.

CONCLUSION:

EUS N-staging still has prognostic value in patients staged N0 at PET/CT. There is a significant difference in survival between EUS N0 and positive nodal EUS status in those staged N0 at PET/CT, suggesting PET/CT is unreliable for local staging. PET/CT and EUS continue to have complimentary roles in OC staging.

PMID:
24916652
DOI:
10.1016/j.crad.2014.04.023
[Indexed for MEDLINE]
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