| Staging and restaging of advanced esophageal cancer. | |
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MedLine Citation:
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PMID: 18622171 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Esophageal cancer staging continues to evolve, especially for advanced cases. Computer tomography (CT) scan of the thorax and abdomen to detect metastatic disease, and endoscopic ultrasound with fine needle aspiration (EUS-FNA) remain the preferred methods. Several recent studies have evaluated alternative methods for locoregional and distant disease detection and staging. RECENT FINDINGS: There seems to be emerging roles for fluorine-18 fluorodeoxyglucose (FDG)-PET, laparoscopic staging, and high-resolution T2-weighted MRI in esophageal cancer staging. Perfusion CT and FDG-PET and FDG-PET/CT may have an emerging role in assessing response to neoadjuvant therapy. Restaging following neoadjuvant therapy remains suboptimal. A 50% or more reduction of tumor thickness by EUS postchemotherapy continues to be the best measure for tumor downstaging survival, while FDG-PET/CT may be more accurate than EUS-FNA and CT scan for predicting nodal status and complete responders after neoadjuvant therapy. Potential methylation analysis, digital image analysis, and fluorescence in-situ hybridization on EUS-FNA samples may increase the yield and prove to be better than routine cytology. SUMMARY: For advanced esophageal cancer, locoregional staging is best performed with EUS-FNA, with CT scan of the thorax and abdomen and FDG-PET, to detect metastatic disease. The role of EUS in restaging following neoadjuvant therapy remains controversial, with recent studies showing that FDG-PET/CT may be more accurate than EUS-FNA and CT scan for predicting nodal status and complete responders after neoadjuvant therapy. |
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Authors:
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Laith H Jamil; Kanwar Rupinder S Gill; Michael B Wallace |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in gastroenterology Volume: 24 ISSN: 1531-7056 ISO Abbreviation: Curr. Opin. Gastroenterol. Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-07-14 Completed Date: 2008-10-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8506887 Medline TA: Curr Opin Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 530-4 Citation Subset: IM |
Affiliation:
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Mayo Clinic, Jacksonville, Florida, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Biopsy, Fine-Needle Diagnostic Imaging Esophageal Neoplasms / pathology*, therapy Humans Laparoscopy Neoplasm Staging / methods* Outcome Assessment (Health Care) Predictive Value of Tests |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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