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. 2000 Jul;47(1):120–125. doi: 10.1136/gut.47.1.120

Evaluation of prognosis of squamous cell carcinoma of the oesophagus by endoscopic ultrasonography

M Shinkai 1, Y Niwa 1, T Arisawa 1, N Ohmiya 1, H Goto 1, T Hayakawa 1
PMCID: PMC1727960  PMID: 10861273

Abstract

BACKGROUND/AIMS—For pretherapeutic staging of squamous cell carcinoma of the oesophagus, endoscopic ultrasonography (EUS) is considered the most profitable modality because it can provide cross sectional imaging of the tumour. The aim of this study was to evaluate the relation between prognosis and EUS findings, especially tumour area, in squamous cell carcinoma of the oesophagus.
PATIENTS/METHODS—A total of 113 patients with squamous cell carcinoma of the oesophagus underwent EUS for pretherapeutic examination at Nagoya University Hospital. We compared EUS findings, histological results, and outcome. In addition, we measured the area of the tumour on EUS images (n=113) and evaluated if EUS area correlated with volume of the tumour on histological findings (n=50).
RESULTS—The overall accuracy rate of EUS was 83.2% (94/113) for depth of tumour invasion and 67.6% (69/102) for perioesophageal lymph node metastasis. The EUS area increased in proportion to the development of tumour infiltration, and patients with lymph node metastasis had a larger EUS area than patients without lymph node metastasis. There was a close correlation between EUS area and volume of the tumour on histological findings. If EUS area of the tumour was less than 50 mm2, the five year survival rate was 100%. As EUS area increased, the survival rate decreased.
CONCLUSIONS—Measurement of EUS area of the tumour is reliable for quantification of the tumour and prediction of prognosis in patients with squamous cell carcinoma of the oesophagus.


Keywords: squamous cell carcinoma; oesophagus; endoscopic ultrasonography; prognosis; preoperative staging

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Figure 1  .

Figure 1  

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Measurement of tumour area, by endoscopic ultrasonography (EUS), and pathological tumour volume. (A) Ultrasound probe image of submucosal cancer. The ultrasound probe reveals a hypoechoic mass region extensively invading into the high echoic third layer (submucosal layer). In this case, the EUS area of the tumour was 36.1 mm2. (B) Histological findings after surgery showed the tumour limited to the submucosa (haematoxylin-eosin, original magnification). Pathological tumour volume (cm3) is the total tumour area (a+b+c+d) (cm2)×width of prepared specimen (0.4 cm) In this case, the pathological tumour volume was 3.20 cm3.

Figure 2  .

Figure 2  

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Correlation between area, measured by endoscopic ultrasonography (EUS), and pathological volume of the tumour. There was a high correlation between EUS area and pathological tumour volume. Pearson's correlation coefficient was 0.92. 

Figure 3  .

Figure 3  

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Kaplan-Meier survival curves for patients with oesophageal cancer, according to area, measured by endoscopic ultrasonography (EUS), of the tumour. Five year survival rates of all patients with a tumour area less than 50 mm2 on EUS findings was 100%.

Figure 4  .

Figure 4  

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Kaplan-Meier survival curves for patients with oesophageal cancer according to depth of tumour invasion. (A) Survival curves according to histological diagnosis. (B) Survival curves according to endoscopic ultrasonography (EUS) findings.

Figure 5  .

Figure 5  

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Kaplan-Meier survival curves for patients with oesophageal cancer according to perioesophageal lymph node metastasis. (A) Survival curves according to histological diagnosis. (B) Survival curves according to endoscopic ultrasonography (EUS) findings. There was a significant difference between positive and negative lymph node metastasis ((A) p<0.001, (B) p=0.0021).

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