SINGLE CENTRE REVIEW OF ENDOSCOPIC ULTRASOUND STAGING ACCURACY IN EARLY OESOPHAGEAL CANCER

Aims To evaluate the accuracy of EUS in early oesophageal cancer T and N staging in a large tertiary care centre.

Methods The upper GI cancer registry was interrogated for pathologically confirmed T1 or T2 cancers post oesophagectomy or endoscopic mucosal resection (EMR). Patients who had a staging EUS in our institution prior to intervention were included. Patients who received neoadjuvant therapy, or those with incomplete staging were excluded. Final pathological staging was correlated with pre-op EUS staging.

Results 43 (14 female, 9 male) patients were included in the study. 34 patients had an oesophagectomy and 9 patients had EMR. The mean age was 68 years (range 48-83 yrs). 36 patients had adenocarcinoma and 7 squamous cell carcinoma (SCC).

The N staging accuracy was 86%. The T staging accuracy was 70%(30/43). On subgroup analysis, 50% (6/12) patient with OGJ pathology were correctly staged. 80% (16/20) patients with lower oesophageal tumours were accurately staged. 70%(7/10) patients with middle oesophageal tumours were accurately staged. A single patient had an upper oesophageal tumour which was accurately staged. 85% (11/13) of staging errors were related to ‘over-staging’ the lesion. The 2 patients who were ‘under-staged’ had surgery with subsequent adjuvant therapy, and are currently disease free (3 year follow up).

Conclusions Our study shows that our rates of accurate EUS staging in early upper GI cancers are comparable to published data. Our data highlights the difficulty of accurately staging junctional tumours.