Abstract
To assess the accuracy and limitations of endoscopic ultrasonography (EUS) in the
preoperative staging of esophageal and gastric carcinoma, we performed a prospective
controlled study over a five year period. Data from 63 patients with esophageal cancer
and 147 patients with gastric cancer who underwent surgery were available for comparison
of the endosonographic TNM classification to the histopathological findings of the
resected specimens. The overall accuracy of EUS in the assessment of tumor infiltration
depth was 85.7 % and 78 % in esophageal and gastric cancer, respectively. The sensitivity
of EUS in the detection of regional lymph node metastases was 90 % in esophageal and
87 % in gastric carcinoma. The most frequent causes of misdiagnoses by endosonography
were microscopic tumor invasion and peritumorous inflammatory changes. The inability
to traverse a tumor stenosis restricted the endosonographic evaluation in 31.6 and
14 % of the cases with esophageal and gastric cancer, respectively.
