Published online Jun 16, 2023. doi: 10.4253/wjge.v15.i6.447
Peer-review started: February 24, 2023
First decision: March 24, 2023
Revised: April 8, 2023
Accepted: May 12, 2023
Article in press: May 12, 2023
Published online: June 16, 2023
Processing time: 110 Days and 5.2 Hours
Endoscopic ultrasound (EUS) stands as an accurate imaging modality for esop
To display the role of EUS in pre-intervention early esophageal cancer staging and how the index endoscopic features of invasive esophageal malignancy compare for prediction of depth of invasion and cancer management.
This was a retrospective study of patients who underwent pre-resection EUS after a diagnosis of esophageal cancer at a tertiary medical center from 2012 to 2022. Patient clinical data, initial esophagogastroduodenoscopy/biopsy, EUS, and final resection pathology reports were abstracted, and statistical analysis was conducted to assess the role of EUS in management decisions.
Forty nine patients were identified for this study. EUS T stage was concordant with histological T stage in 75.5% of patients. In determining submucosal involvement (T1a vs T1b), EUS had a specificity of 85.0%, sensitivity of 53.9%, and accuracy of 72.7%. Endoscopic features of tumor size > 2 cm and the presence of esophageal ulceration were significantly associated with deep invasion of cancer on histology. EUS affected management from endoscopic mucosal resecti
EUS was reasonably specific in ruling out submucosal invasion but had relatively poor sensitivity. Data validated endoscopic indicators suggested superficial cancers in the group with a tumor size < 2 cm and the lack of esophageal ulceration. In patients with these findings, EUS rarely identified a deep cancer that warranted a change in management.
Core Tip: This study aims to convey the role of endoscopic ultrasound (EUS) for early esophageal cancer considered for endoscopic or surgical resection and how the index endoscopic features of esophageal malignancy compare for prediction of depth of invasion and cancer management. This was a retrospective study of 49 patients who underwent pre-resection EUS after diagnosis of esophageal cancer. EUS was reasonably specific in ruling out submucosal invasion but had relatively poor sensitivity. Data validated endoscopic features suggesting superficial cancers including a tumor size < 2 cm and the lack of esophageal ulceration. In patients with these findings, EUS rarely identified a deep cancer that warranted a change in management.