Original ArticlesHelical CT versus EUS with fine needle aspiration for celiac nodal assessment in patients with esophageal cancer☆,☆☆
Section snippets
Patients and methods
Local institutional review board ethical approval and informed consent was obtained before commencement of this study. Consecutive patients referred with untreated esophageal cancer were recruited. Demographics, dysphagia scores, symptom durations, and tumor characteristics (pathology, location, size) were noted.
The hCT was performed in all patients and TNM staging, including the identification of distant metastases, was prospectively reported by a single GI CT radiologist, including those hCT
Demographics and spectrum of disease
Forty-eight patients (37 men [77%]; mean age 63.6 [10], range 47-91 years) with esophageal cancer were recruited into the study and underwent both an EUS and a hCT without prior adjuvant chemotherapy or radiotherapy. There were 37 men (77%) and the mean age was 63.6 (± 10) years (range 47-91). Twenty patients were African American (42%); one patient was Asian American; the remainder were white. The biopsy results indicated a diagnosis of adenocarcinoma in 17 (35%), with the remainder being
Discussion
The management of esophageal cancer is evolving, and the question of whether all patients with curable disease should undergo aggressive surgical therapy is being asked. In addition, advances in nonsurgical options for palliative therapy of esophageal cancer, including Nd-YAG laser photoablation, argon plasma coagulation, photodynamic therapy, and insertion of metal stents, have made accurate nonoperative staging increasingly important to avoid unnecessary surgical morbidity in patients with
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2011, Clinical Colorectal CancerCitation Excerpt :Meanwhile, further recruitment is ongoing. The lack of correlation of expression profiles with CT response likely reflects the difficulties of accurately assessing these tumors using this modality.20–22 However, expression profiles based on EUS response utilizing tumor thickness were able to distinguish between stable disease and responders.
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Dr. Wallace is funded by the American Digestive Health Foundation: Wilson Cook Endoscopic Research Award and TAP Pharmaceutical Outcomes Research Award. Dr. Romagnuolo is funded by the Alberta Heritage Foundation for Medical Research.
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Reprint requests: Michael B. Wallace, MD, MUSC Digestive Disease Center, 96 Jonathon Lucas St., Suite 922 CSB, Charleston, SC 29425.