Computed tomography for staging esophageal and gastroesophageal cancer: reevaluation

A reevaluation of computed tomography (CT) for staging carcinoma of the esophagus and gastroesophageal junction was performed in 76 patients. For comparison 26 patients without carcinoma of the esophagus with a normal mediastinum at surgery were included in the evaluation. Four radiologists evaluated the CT scans without knowledge of the diagnosis. After determining if there was an adequate amount of fat, they were asked to evaluate each case for the presence or absence of local invasion and distant metastases. The radiologists correctly identified all 26 normal patients. Eighteen of the 76 carcinoma patients had a paucity of fat, but only six were thought to have truly indeterminate scans. CT correctly identified 40 of the 44 esophageal carcinoma patients with mediastinal invasion and 11 of the 15 patients without invasion (accuracy 88%). CT correctly identified 15 of 19 patients with distant abdominal metastases and 28 of 30 patients without metastases (accuracy 88%). CT was only 50% accurate in predicting the presence or absence of invasion in the 12 patients with gastroesophageal junction tumors and only 58% accurate in predicting distant metastases. CT correctly staged 46 (94%) of 49 patients with esophageal carcinoma but only five (42%) of 12 patients with gastroesophageal junction tumors. These results confirm that CT should be used as a major staging method in all patients with esophageal carcinoma.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				Y. Yamabe, Y. Kuroki, T. Ishikawa, K. Miyakawa, S. Kuroki, and R. Sekiguchi Tumor Staging of Advanced Esophageal Cancer: Combination of Double-Contrast Esophagography and Contrast-Enhanced CT Am. J. Roentgenol., September 1, 2008; 191(3): 753 - 757. [Abstract] [Full Text] [PDF]

				M. J. Gollub, R. Lefkowitz, C. S. Moskowitz, D. Ilson, D. Kelsen, and H. Felderman Pelvic CT in Patients with Esophageal Cancer Am. J. Roentgenol., February 1, 2005; 184(2): 487 - 490. [Abstract] [Full Text] [PDF]

				Y. Nishimura, H. Osugi, K. Inoue, N. Takada, M. Takamura, and H. Kinosita Bronchoscopic Ultrasonography in the Diagnosis of Tracheobronchial Invasion of Esophageal Cancer J. Ultrasound Med., January 1, 2002; 21(1): 49 - 58. [Abstract] [Full Text] [PDF]

				M. J. Krasna, C. E. Reed, D. Nedzwiecki, D. R. Hollis, J. D. Luketich, M. M. DeCamp, R. J. Mayer, and D. J. Sugarbaker CALGB 9380: a prospective trial of the feasibility of thoracoscopy/laparoscopy in staging esophageal cancer Ann. Thorac. Surg., April 1, 2001; 71(4): 1073 - 1079. [Abstract] [Full Text] [PDF]

				A Melville, A Eastwood, E Morris, and D Forman Management of upper gastrointestinal cancers Qual. Saf. Health Care, March 1, 2001; 10(1): 57 - 64. [Full Text]

				C. Chiles, K. W. Davis, and D. W. Williams III Navigating the Thoracic Inlet RadioGraphics, September 1, 1999; 19(5): 1161 - 1176. [Abstract] [Full Text] [PDF]