Preoperative Staging of Esophageal Cancer
- January 31, 2019
The clinical presentation of esophageal cancer (EC) in all over the world has been changing but remains a dreadful disease. Patients with EC after a prolonged asymptomatic preclinical period commonly present with advanced inoperable disease and a very poor prognosis. Once a diagnosis of esophageal cancer has been made, the patient should then undergo a complete staging assessment. Reliable and precise pretreatment clinical staging information is crucial to providing the patient with an accurate prediction of survival and to determining appropriate management options.
Current guidelines for EC staging, which is critical for treatment decisions, include abdominal and chest CT, EUS, and PET/CT. However, these options come with certain limitations, which could be addressed by the newer hybrid modality.
Dr. Geewon Lee and colleagues from Pusan National University Hospital in Busan had compare the results of EUS, CT, PET/MR imaging and PET/CT for the preoperative local and regional staging of esophageal cancer, with postoperative pathologic stage used as the reference standard.
The study was unique in that it compared four modalities’ performance, according to Lee and colleagues. They believe that only a few studies have evaluated the role of conventional MRI, which is generally not part of the standard imaging protocol.
“PET/MR imaging demonstrated acceptable accuracy for T staging compared with EUS and, although not statistically significant, even higher accuracy than EUS and PET/CT for prediction of N staging. Therefore, our results suggest that with protocol adjustments, PET/MRI may be used clinically for the preoperative staging of EC in the future,” concluded lead author Dr. Geewon Lee and colleagues.
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