This was an original article presented at the Association of Surgeons of Great Britain and Ireland, Cardiff, 2007.
Prognostic significance of failure to cross esophageal tumors by endoluminal ultrasound
Article first published online: 22 APR 2008
© 2008 Copyright the Authors. Journal compilation © 2008, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus
Diseases of the Esophagus
Volume 21, Issue 6, pages 508–513, September 2008
How to Cite
Morgan, M. A., Twine, C. P., Lewis, W. G., Lambe, R., Oliphant, H. E., Robinson, M., Crosby, T. D. L. and Roberts, S. A. (2008), Prognostic significance of failure to cross esophageal tumors by endoluminal ultrasound. Diseases of the Esophagus, 21: 508–513. doi: 10.1111/j.1442-2050.2008.00809.x
- Issue published online: 28 AUG 2008
- Article first published online: 22 APR 2008
- esophageal cancer;
SUMMARY. Failure to intubate and cross esophageal tumors by endosonography is reported in as many as 30% of cases and is thought to be associated with an especially poor prognosis. The aim of this study was to audit the above in a large consecutive case series of Endoscopic Ultrasound (EUS) examinations for esophageal cancer performed in a regional specialist cancer network with particular reference to outcome. A consecutive series of 411 patients underwent EUS examination by a specialist radiologist over a period of 9 years. Forty (10%) of patients required dilation, and there was total failure to cross the tumor in 12 patients (2.9%). Failure to traverse the primary tumor was associated with a diagnosis of squamous cell cancer (8 of 12 patients, 66%, rho = −0.182, P = 0.011). Limited staging information was obtained in 7 of these patients, which altered the computed tomography stage in 5 patients (71%, 3 upstaged, 2 downstaged). Six patients received definitive chemoradiotherapy, two patients surgery and four patients palliative chemotherapy. The median and 5-year survival in patients whose tumors were not crossed was 10 months and 28%, respectively, compared with 24 months and 24%, respectively in patients whose tumors were fully assessed. Failure to cross esophageal tumors in practice was far less common than the literature suggests, and esophageal tumor luminal stenosis should no longer be considered a limitation of endosonography.