COMPARING THE ACCURACY OF EUS AND CT IN STAGING OF ESOPHAGEAL CANCER

Aims Endoscopic ultrasound (EUS) is a suitable device for staging of esophageal cancers. However, chest computed tomography (CT) has traditionally been the standard diagnostic modality for malignancies. This study aimed was to compare the accuracies of EUS and chest CT in T and N staging of esophageal cancers.

Methods We retrospectively analyzed 149 patients who had undergone EUS examination and 275 patients who had undergone chest CT before cancer surgery. The inclusion criteria were:

1. patients diagnosed with esophageal cancer on biopsy,

2. patients who had undergone EUS examination or chest CT before cancer surgery, and

3. patients who underwent cancer surgery at the Seoul National University Bundang Hospital from May 2003 to December 2018.

We determined the accuracy of T and N staging on EUS examination and chest CT with the biopsy specimens.

Results The overall accuracies of EUS examination and chest CT were 72.5% (108/149) and 68.7% (189/275), respectively, for T staging (p = 0.487) and 64.4% (96/149) and 61.5% (169/275), respectively, for N staging, which was not statistically different (p = 0.596). For the substaging, the accuracy of EUS examination was not statistically different than that of chest CT for the T, N stage.

Conclusions EUS examination is not superior to chest CT for diagnosing T stage in esophageal cancers, whereas chest CT is not superior to EUS examination for diagnosing N stage in esophageal cancers. EUS examination and chest CT are not satisfactory for diagnosing T, N stage in esophageal cancers. Futher study is needed for accurate T, N stage diagnosis in esophageal cancer.