Abstract
One hundred and sixty seven consecutive patients with esophageal carcinoma (squamous
cell carcinoma: n = 108, adenocarcinoma: n = 59) who underwent surgery were preoperatively
examined by endoscopic ultrasonography (EUS), and the results were compared with intraoperative
exploration and histopathological evaluation of resection specimens. The T and N stage
were correctly determined by EUS in 86 % and 73 %, respectively. The assessment of
the T stage for cases with traversable (n = 124) versus non-traversable (n = 43) tumor
stenoses was 85 % and 70 %, respectively. Prediction of resectability by EUS (89 %)
was correct for adenocarcinoma (82 % actual R0 resection rate), but not for squamous
cell cancer (64 %). This was due to the high incidence of submucosal microscopic tumor
spread of squamous cell cancer not detectable on EUS. We consider EUS an indispensable
diagnostic tool in the local staging of esophageal cancer since it provides important
information in the assessment of resectability, aids in therapeutic decisions and
in determining the prognosis. Our comparably low rate of primary surgery (66 %) and
the high resection rate of 95 % are due to the exact preoperative staging by EUS.
