The Accuracy of Endosonographic Staging and the Posible Prognostic Factors in Esophageal Squamous Cell Carcinoma: An Experience from Southern Taiwan

食道扁平細胞癌在內視鏡超音波分期的準確性及預後分析：南台灣的經驗

胡銘倫(Ming-Luen Hu) ； 張簡吉幸(Chi-Sin Changchien) ； 李全謨(Chuan-Mo Lee) ； 戴維震(Wei-Chen Tai) ； 蔡成枝(Seng-Kee Chuah) ； 吳耿良(Keng-Liang Wu) ； 邱逸群(Yi-Chun Chiu) ； 趙景華(King-Wah Chiu)

《臺灣消化醫學雜誌》 27卷3期 (2010/09) Pp. 252-260

https://doi.org/10.6557/GJT.201009_27(3).0003

摘要

Background and Aim: Esophageal squamous cell carcinoma (SCC) is related to smoking and drinking. Betel nut chewing is prevalent in southern Taiwan and is also a risk factor of esophageal SCC. The study aimed to evaluate the accuracy of EUS in staging esophageal SCC and the possible prognostic factors.
Materials and Methods: Eighty-seven patients with esophageal SCC undergoing pretreatment EUS were enrolled from January 2002 to December 2005. Using pathological stages as the gold standard in the 22 operative patients, the EUS accuracy in determining tumor (T) and nodal (N) stages were evaluated. We recorded patient age, tumor location, EUS staging and personal habits including smoking, drinking and betel nut chewing as variables and try to seek the possible prognostic factors.
Results: In total 22 operative patients, the EUS accuracies in T1, T2, T3, T4 and N1 were 86.4%, 63.7%, 50.0%, 72.7% and 36.4%, respectively and increased to 100%, 90.9%, 90.9%, 100% and 45.5% in 11 operative patients without chemoradiotherapy interference. Median survivals for 87 patients in pretreatment EUS stage Tis/T1/T2 (not available due to good prognosis), stage T3 (29.9 months), and stage T4 (7.2 months) were statistically different (P＜0.001). Pretreatment EUS T staging and betel nut chewing were the prognostic factors and EUS T staging was the only independent predictor.
Conclusions: EUS T staging is useful in pretreatment esophageal SCC and is the only independent prognostic factor. But the accuracy of N staging is not as good as T staging, the effort toward the accurate N staging is necessary.

關鍵字

內視鏡超音波 ； 食道扁平細胞癌 ； 分期準確性

並列摘要

Background and Aim: Esophageal squamous cell carcinoma (SCC) is related to smoking and drinking. Betel nut chewing is prevalent in southern Taiwan and is also a risk factor of esophageal SCC. The study aimed to evaluate the accuracy of EUS in staging esophageal SCC and the possible prognostic factors.
Materials and Methods: Eighty-seven patients with esophageal SCC undergoing pretreatment EUS were enrolled from January 2002 to December 2005. Using pathological stages as the gold standard in the 22 operative patients, the EUS accuracy in determining tumor (T) and nodal (N) stages were evaluated. We recorded patient age, tumor location, EUS staging and personal habits including smoking, drinking and betel nut chewing as variables and try to seek the possible prognostic factors.
Results: In total 22 operative patients, the EUS accuracies in T1, T2, T3, T4 and N1 were 86.4%, 63.7%, 50.0%, 72.7% and 36.4%, respectively and increased to 100%, 90.9%, 90.9%, 100% and 45.5% in 11 operative patients without chemoradiotherapy interference. Median survivals for 87 patients in pretreatment EUS stage Tis/T1/T2 (not available due to good prognosis), stage T3 (29.9 months), and stage T4 (7.2 months) were statistically different (P＜0.001). Pretreatment EUS T staging and betel nut chewing were the prognostic factors and EUS T staging was the only independent predictor.
Conclusions: EUS T staging is useful in pretreatment esophageal SCC and is the only independent prognostic factor. But the accuracy of N staging is not as good as T staging, the effort toward the accurate N staging is necessary.

並列關鍵字

endoscopic ultrasonography ； esophageal squamous cell carcinoma ； staging accuracy