Skip to main content

Advertisement

SpringerLink
Log in

The preferred choice for radial endosonographic staging of esophageal cancer: standard echoendoscope or nonoptic esophagoprobe?

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The nonoptic esophagoprobe has been reported to be comparable to the standard echoendoscope in esophageal cancer staging, with a superior advantage of traversing more stenotic tumors because of its smaller diameter. The aim of this study was to see whether its use in a general population of esophageal cancer patients confers any significant clinical benefit.

Methods

Five hundred seventy-seven consecutive patients referred for initial locoregional staging of esophageal cancer were analyzed retrospectively. Comparisons were made between the standard echoendoscope and the esophagoprobe.

Results

Complete staging (95.2% vs 77.5%; p < 0.001) was significantly higher in the esophagoprobe group compared with that of the standard echoendoscope group (315 and 262 patients, respectively). In 146 patients with histopathologic verification without prior chemotherapy or radiotherapy, the esophagoprobe was comparable in T-staging accuracy to the standard echoendoscope in those with traversable tumors (89.2% vs. 82.8%; p = 0.213). However, the presence of a nontraversable stricture significantly decreased standard echoendoscope T-staging accuracy compared with a traversable stricture (33.3% vs. 82.8%, respectively; p < 0.001). The esophagoprobe also picked more advanced tumors and distal nodes.

Conclusions

The esophagoprobe is more accurate than the standard echoendoscope in the T staging of esophageal cancer because of its higher likelihood of traversing tumor stenosis. It can potentially reduce the necessity for dilation in stenotic tumors by four to five times. We propose using the esophagoprobe as the first choice for radial endoscopic ultrasound staging of esophageal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.

Similar content being viewed by others

References

  1. Beseth BD, Bedford R, Isacoff WH, Holmes CE, Cameron RB (2000) Endoscopic ultrasound does not accurately assess pathologic stage of esophageal cancer after neoadjuvant chemoradiotherapy. Am Surg 66: 827–831

    PubMed  CAS  Google Scholar 

  2. Bhutani MS, Hawes RH, Hoffman BJ (1997) A comparison of the accuracy of echo features during endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration for diagnosis of malignant lymph node invasion. Gastrointest Endosc 45: 474–479

    Article  PubMed  CAS  Google Scholar 

  3. Binmoeller KF, Seifert H, Seitz U, Izbicki JR, Kida M, Soehendra N (1995) Ultrasonic esophagoprobe for TNM staging of highly stenosing esophageal carcinoma. Gastrointest Endosc 41: 547–552

    Article  PubMed  CAS  Google Scholar 

  4. Botet JF, Lightdale CJA, Zauber G, Gerdes H, Urmacher C, Brennan MF (1991) Preoperative staging of esophageal cancer: comparison of endoscopic US and dynamic CT. Radiology 181: 419–425

    PubMed  CAS  Google Scholar 

  5. Bowrey DJ, Clark GWB, Roberts SA, Maughan TS, Hawthorne AB, Williams GT, Carey PD (1999) Endosonographic staging of 100 consecutive patients with esophageal carcinoma: introduction of the 8-mm esophagoprobe. Dis Esophagus 12: 258–263

    Article  PubMed  CAS  Google Scholar 

  6. Catalano MF, Sivak MV Jr, Rice T, Gragg LA, Van Dam J (1994) Endosonographic features predictive of lymph node metastasis. Gastrointest Endosc 40: 442–446

    Article  PubMed  CAS  Google Scholar 

  7. Catalano MF, Van Dam J, Sivak MV Jr (1995) Malignant esophageal strictures: staging accuracy of endoscopic ultrasonography. Gastrointest Endosc 41: 535–539

    Article  PubMed  CAS  Google Scholar 

  8. Chak A, Soweid A, Hoffman B, Stevens P, Hawes RH, Lightdale CJ, Cooper GS, Canto MI, Sivak MV Jr (1998) Clinical implications of endoluminal ultrasonography using through-the-scope catheter probes. Gastrointest Endosc 48: 485–490

    Article  PubMed  CAS  Google Scholar 

  9. Dittler HJ, Siewert JR (1993) Role of endoscopic ultrasonography in esophageal carcinoma. Endoscopy 25: 224–230

    Google Scholar 

  10. Grimm H, Binmoeller KF, Hamper K, Koch J, Henne-Bruns D, Soehendra N (1993) Endosonography for the preoperative locoregional staging of esophageal and gastric cancer. Endoscopy 25: 224–230

    PubMed  CAS  Google Scholar 

  11. Hasegawa N, Niwa Y, Arisawa T, Hase S, Goto H, Hayakawa T (1996) Preoperative staging of superficial esophageal carcinoma: comparison of an ultrasound probe and standard endoscopic ultrasonography. Gastrointest Endosc 44: 388–393

    Article  PubMed  CAS  Google Scholar 

  12. Hordijk ML, Zander H, van Blankenstein M, Tilanus HW (1993) Influence of tumor stenosis on the accuracy of endosonography in preoperative T staging of esophageal cancer. Endoscopy 25: 171–175

    PubMed  CAS  Google Scholar 

  13. Isenberg G, Chak A, Canto MI, Levitan N, Clayman J, Pollack BJ, Sivak MV Jr (1998) Endoscopic ultrasound in restaging of esophageal cancer after neoadjuvant chemoradiation. Gastrointest Endosc 48: 158–163

    Article  PubMed  CAS  Google Scholar 

  14. Kallimanis GE, Gupta PK, Al-Kawas FH, Tio LT, Benjamin SB, Bertagnolli ME, Nguyen CC, Gomes MN, Fleischer DE (1995) Endoscopic ultrasound for staging esophageal cancer, with or without dilation, is clinically important and safe. Gastrointest Endosc 41: 540–546

    Article  PubMed  CAS  Google Scholar 

  15. Kelly S, Harris KM, Berry E, Hutton J, Roderick P, Cullingworth J, Gathercole L, Smith MA (2001) A systematic review of the staging performance of endoscopic ultrasound in gastro-oesophageal carcinoma. Gut 49: 534–539

    Article  PubMed  CAS  Google Scholar 

  16. Langdon DF (1997) The rule of three in oesophageal dilatation. Gastrointest Endosc 45: 111

    PubMed  CAS  Google Scholar 

  17. Mallery S, Van Dam J (1999) Increased rate of complete EUS staging of patients with esophageal cancer using the non-optical, wire-guided echoendoscope. Gastrointest Endosc 50: 53–57

    Article  PubMed  CAS  Google Scholar 

  18. Medical Research Council Oesophageal Cancer Working Party (2002) Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet 359: 1727–1733

    Article  Google Scholar 

  19. Menzel J, Hoepffner, Nottberg H, Schulz C, Senninger N, Domschke W (1999) Preoperative staging of esophageal carcinoma: miniprobe sonography versus conventional endoscopic ultrasound in a prospectively histopathologically verified study. Endoscopy 31: 291–297

  20. Pfau PR, Ginsberg GG, Lew RJ, Faigel DO, Smith DB, Kochman ML (2000) Esophageal dilation for endosonographic evaluation of malignant esophageal strictures is safe and effective. Am J Gastroenterol 95: 2813–2815

    Article  PubMed  CAS  Google Scholar 

  21. Pfau PR, Ginsberg GG, Lew RJ, Brensinger CM, Kochman ML. (2001) EUS predictors of long-term survival in esophageal carcinoma. Gastrointest Endosc 53: 463–469

    Article  PubMed  CAS  Google Scholar 

  22. Quine MA, Bell GD, McCloy RF, Matthews HR (1995) Prospective audit of perforation rates following upper gastrointestinal endoscopy in two regions of England. Br J Surg 82: 530–533

    Article  PubMed  CAS  Google Scholar 

  23. Quint LE, Hepburn LM, Francis IR, Whyte RI, Orringer MB (1995) Incidence and distribution of distant metastases from newly diagnosed esophageal carcinoma. Cancer 76: 1120–1125

    Article  PubMed  CAS  Google Scholar 

  24. Rosch T (1995) Endosonographic staging of esophageal cancer: a review of literature results. Gastrointest Endosc Clin North Am 5: 537–547

    CAS  Google Scholar 

  25. Siemsen M, Svendsen LB, Knigge U, Vilmann P, Jensen F, Rasch L, Stentoft P (2003) A prospective randomized comparison of curved array and radial echoendoscopy in patients with esophageal cancer. Gastrointest Endosc 58: 671–676

    Article  PubMed  Google Scholar 

  26. Van Dam J, Rice TW, Catalano MF, Kirby T, Sivak MV Jr (1993) High-grade malignant stricture is predictive of esophageal tumor stage: risks of endosonographic evaluation. Cancer 71: 2910–2917

    Article  PubMed  Google Scholar 

  27. Van Dam J (1997) Endosonographic evaluation of the patient with esophageal cancer. Chest 112: 184S–90S

    PubMed  Google Scholar 

  28. Vazquez-Sequeiros E, Norton ID, Clain JE, Wang KK, Affi A, Allen M, Deschamps C, Miller D, Salomao D, Wiersema MJ (2001) Impact of EUS-guided fine-needle aspiration on lymph node staging in patients with esophageal carcinoma. Gastrointest Endosc 53: 751–757

    Article  PubMed  CAS  Google Scholar 

  29. Vilgrain V, Mompoint D, Palazzo L, Menu Y, Gayet B, Oliier P, Nahum H, Fekete F (1991) Staging of oesophageal carcinoma: comparison of results with endoscopic sonography and CT. Am J Radiol 155: 277–281

    Google Scholar 

  30. Wallace MB, Hawes RH, Sahai AV, Van Velse A, Hoffman BJ (2000) Dilation of malignant esophageal stenosis to allow EUS guided fine-needle aspiration: safety and effect on patient management. Gastrointest Endosc 51: 309–313

    Article  PubMed  CAS  Google Scholar 

  31. Zuccaro G Jr, Rice TW, Goldblum J, Medendorp SV, Becker M, Pimental R, Gitlin L, Adelstein DJ (1999) Endoscopic ultrasound cannot determine suitability for esophagectomy after aggressive chemo-therapy for esophageal cancer. Am J Gastroenterol 94: 906–912

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Tan Tock Seng Hospital, Tan Tock Seng, Singapore

    C. Vu

  2. Department of Gastroenterology, St. Thomas’ Hospital, London, UK

    S. Tsang, L. Doig & J. Meenan

Authors
  1. C. Vu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Tsang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Doig
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Meenan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Vu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vu, C., Tsang, S., Doig, L. et al. The preferred choice for radial endosonographic staging of esophageal cancer: standard echoendoscope or nonoptic esophagoprobe?. Surg Endosc 21, 1617–1622 (2007). https://doi.org/10.1007/s00464-007-9206-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-007-9206-z

Keywords

Search

Navigation