TY - JOUR
T1 - Endoscopic ultrasound prediction of survival in esophageal cancer
AU - Stotland, B. R.
AU - Ginsberg, G. O.
AU - Faigel, D. O.
AU - Smith, D.
AU - Lewis, J. D.
AU - Kochman, M. L.
PY - 1997
Y1 - 1997
N2 - Endoscopic ultrasound (EUS) has been shown to be the most accurate imaging modality for preoperative T- and N- staging in esophageal cancer. Esophageal cancer (EsoCa) often presents at an advanced stage, but a subset of patients may be cured by surgery. We prospectively followed patients after EUS for EsoCa staging to determine the utility of EUS in predicting survival. Methods: 91 consecutive patients who underwent EUS (Olympus GF-UM20) for Eca over a 42 month period were reviewed. Survival data was obtained on 56 patients. Results: For those with surgical pathologic staging, EUS had a 70% T-stage accuracy and an 84% N-stage accuracy. Survival data are based on EUS T- and N-stage are depicted below. There was a trend towards lower survival with higher T-stage. This was significant at 6 mo. for T4 vs. T3 (RR 0.38, 0.15-0.97) and for T4 vs. all others combined (RR 0.33, 0.14-0.77). There was a trend for decreased survival for N1 lesions which approached statistical significance (p<0.16 at 6 mo., p<0.16 at 9 mo., p< 0.12 at 12 mo., p<0.10 at 15 mo.)[Fisher's two-tailed exact test]. Survival in months by EUS T- and N-stage # Alive 3 mo 6 mo 9 mo 12 mo 15 mo 18 mo 24 mo T1 3/3 2/2 2/2 1/1 1/1 1/1 T2 13/14 9/11 8/10 6/9 5/9 4/9 1/5 T3 26/28 16/21 14/20 10/17 8/16 5/9 2/6 T4 8/9 3/8 1/2 1/2 N0 9/9 7/7 7/7 5/5 4/4 4/4 1/1 N1 41/45 23/35 18/27 13/24 10/22 6/15 2/10 Total 50/54 30/42 25/34 18/29 14/26 10/19 3/11 Conclusions: (1) EUS had a 70% T-stage accuracy and an 84% N-stage accuracy. (2) EUS T-staging predicts decreased survival for T4 lesions when compared with other all other lesions at 6 mo. (3) There is trend towards lower survival with each higher T stage at 6, 9, 12 and 15 mo. (4) At 6 mo. there is a strong trend towards decreased survival associated with the presence of malignant appearing nodes. (5) With a greater duration of follow-up from our cohort, we expect differences in survival based on EUS T- and N-stage to obtain greater statistical significance.
AB - Endoscopic ultrasound (EUS) has been shown to be the most accurate imaging modality for preoperative T- and N- staging in esophageal cancer. Esophageal cancer (EsoCa) often presents at an advanced stage, but a subset of patients may be cured by surgery. We prospectively followed patients after EUS for EsoCa staging to determine the utility of EUS in predicting survival. Methods: 91 consecutive patients who underwent EUS (Olympus GF-UM20) for Eca over a 42 month period were reviewed. Survival data was obtained on 56 patients. Results: For those with surgical pathologic staging, EUS had a 70% T-stage accuracy and an 84% N-stage accuracy. Survival data are based on EUS T- and N-stage are depicted below. There was a trend towards lower survival with higher T-stage. This was significant at 6 mo. for T4 vs. T3 (RR 0.38, 0.15-0.97) and for T4 vs. all others combined (RR 0.33, 0.14-0.77). There was a trend for decreased survival for N1 lesions which approached statistical significance (p<0.16 at 6 mo., p<0.16 at 9 mo., p< 0.12 at 12 mo., p<0.10 at 15 mo.)[Fisher's two-tailed exact test]. Survival in months by EUS T- and N-stage # Alive 3 mo 6 mo 9 mo 12 mo 15 mo 18 mo 24 mo T1 3/3 2/2 2/2 1/1 1/1 1/1 T2 13/14 9/11 8/10 6/9 5/9 4/9 1/5 T3 26/28 16/21 14/20 10/17 8/16 5/9 2/6 T4 8/9 3/8 1/2 1/2 N0 9/9 7/7 7/7 5/5 4/4 4/4 1/1 N1 41/45 23/35 18/27 13/24 10/22 6/15 2/10 Total 50/54 30/42 25/34 18/29 14/26 10/19 3/11 Conclusions: (1) EUS had a 70% T-stage accuracy and an 84% N-stage accuracy. (2) EUS T-staging predicts decreased survival for T4 lesions when compared with other all other lesions at 6 mo. (3) There is trend towards lower survival with each higher T stage at 6, 9, 12 and 15 mo. (4) At 6 mo. there is a strong trend towards decreased survival associated with the presence of malignant appearing nodes. (5) With a greater duration of follow-up from our cohort, we expect differences in survival based on EUS T- and N-stage to obtain greater statistical significance.
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U2 - 10.1016/S0016-5107(97)80628-1
DO - 10.1016/S0016-5107(97)80628-1
M3 - Article
AN - SCOPUS:33748962589
SN - 0016-5107
VL - 45
SP - AB182
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 4
ER -