| Tumor staging of advanced esophageal cancer: combination of double-contrast esophagography and contrast-enhanced CT. | |
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MedLine Citation:
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PMID: 18716105 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study was to compare the diagnostic accuracy of tumor staging in patients with advanced esophageal cancer based on contrast-enhanced CT findings alone with that based on a combination of CT and double-contrast esophagography and to evaluate the relevance of tumor stage to survival rate. MATERIALS AND METHODS: In 94 patients who underwent surgery as the primary treatment for esophageal cancer and had a diagnosis of postoperative T stage 3 (pT3) or pT4 disease based on pathologic examination, T stage was evaluated using CT alone and using a combination of CT and double-contrast esophagography. The diagnostic criterion for T4 disease using CT alone was tumor strongly displacing or deforming adjacent organs. The diagnostic criterion for T4 disease using the combined method was tumor displacing or deforming adjacent organs in the direction that corresponded to the direction of the location of the tumor or the deepest ulcer as diagnosed by barium esophagography. Concordance of T staging based on imaging with postoperative T staging based on pathology results, the gold standard, and survival rate were assessed for CT alone and for the combined method. RESULTS: The concordance rate with postoperative T staging pathology results was 78% for CT alone and 84% for CT and double-contrast esophagography combined, with a significant difference between the two diagnostic methods. For patients with a diagnosis of T3 and those with a diagnosis of T4 using CT alone, the 3-year survival rate was 42% and 26%, respectively, with no significant difference between the two. For patients with a diagnosis of T3 and those with a diagnosis of T4 using the combined method, the 3-year survival rate was 42% and 21%, respectively, with a significant difference between the two. CONCLUSION: The diagnostic performance of contrast-enhanced CT and double-contrast esophagography combined in staging advanced esophageal tumors is better than that of CT alone and thus has potential for estimating prognosis. |
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Authors:
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Yuichiro Yamabe; Yoshifumi Kuroki; Tsutomu Ishikawa; Kunihisa Miyakawa; Seiko Kuroki; Ryuzo Sekiguchi |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 191 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-08-21 Completed Date: 2008-09-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 753-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Diagnostic Imaging, Tochigi Cancer Center, 4-9-13 Yonan, Utsunomiya-shi, Tochigi 3200834, Japan. y-yamabe@jb3.so-net.ne.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Barium Sulfate / diagnostic use* Contrast Media Esophageal Neoplasms / radiography* Female Humans Iodine / diagnostic use* Male Middle Aged Neoplasm Staging Radiographic Image Enhancement / methods* Reproducibility of Results Sensitivity and Specificity Tomography, X-Ray Computed / methods* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 7553-56-2/Iodine; 7727-43-7/Barium Sulfate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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