Original articleGeneral thoracicEndobronchial Ultrasonography Added to Endoscopic Ultrasonography Improves Staging in Esophageal Cancer
Section snippets
Patients and Methods
The study consisted of a prospective clinical trial (clinicaltrials.gov NCT01038544). Consecutive patients with potentially resectable esophageal cancer (based on CT and PET-CT), referred for echoendoscopic staging at the Centre Hospitalier de l’Université de Montréal (CHUM) Endoscopic Tracheobronchial and Oesophageal Center (C.E.T.O.C.), Division of Thoracic Surgery, University of Montreal, were prospectively enrolled. Potential resectability was determined by one of five general thoracic
Results
Between January 2010 and September 2011 (21 months), 52 patients were enrolled into the trial. Ten patients were excluded (1, no tumor; 1, gastric cancer; 8, no EBUS). The combined EBUS-EUS procedure was performed in 42 consecutive patients. There were 8 patients enrolled in the trial who had esophageal cancer but did not undergo EBUS, owing to the endoscopists’ judgment at the time of echoendoscopic staging that the addition of EBUS to EUS in the clinical setting was unnecessary or superfluous.
Comment
Progression of disease from primary site to lymph nodes follows lymphatic drainage. Any lymph node surrounding the esophagus can be affected; that is especially true in esophageal cancer because the lymphatic drainage of the esophagus is not necessarily segmental and predictable, but more longitudinal with skip metastasis [12]. More often than not lymph nodes surrounding the primary tumor are affected by metastatic spread and biopsy is necessary to obtain a tissue diagnosis. Even though several
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