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==Overview==
==Overview==
Other diagnostic studies for esophageal cancer include [[FDG-PET]] (positron emission tomography) scan and [[endoscopic ultrasound]] (EUS).
Laparoscopy, [[thoracoscopy]] and [[bronchoscopy]] can be used in addition to [[Endoscopic ultrasound|EUS]] and [[Computed tomography|CT]] in locally advanced esophageal cancer to accurately diagnose and stage lymph node metastasis.


==Other Diagnostic Studies==
==Other Diagnostic Studies==


==Fludeoxyglucose Positive Emission Tomography==
===Laparoscopy and Thoracoscopy===
[[FDG-PET]] (positron emission tomography) scan is also being used to estimate whether enlarged masses are metabolically active, indicating faster-growing cells that might be expected in cancer.  Esophageal [[endoscopic ultrasound]] (EUS) can provide staging information regarding the level of tumor invasion, and possible spread to regional lymph nodes.<ref name="pmid23247658">{{cite journal |vauthors=Cheedella NK, Suzuki A, Xiao L, Hofstetter WL, Maru DM, Taketa T, Sudo K, Blum MA, Lin SH, Welch J, Lee JH, Bhutani MS, Rice DC, Vaporciyan AA, Swisher SG, Ajani JA |title=Association between clinical complete response and pathological complete response after preoperative chemoradiation in patients with gastroesophageal cancer: analysis in a large cohort |journal=Ann. Oncol. |volume=24 |issue=5 |pages=1262–6 |year=2013 |pmid=23247658 |pmc=3629896 |doi=10.1093/annonc/mds617 |url=}}</ref><ref name="pmid20876421">{{cite journal |vauthors=Monjazeb AM, Riedlinger G, Aklilu M, Geisinger KR, Mishra G, Isom S, Clark P, Levine EA, Blackstock AW |title=Outcomes of patients with esophageal cancer staged with [¹⁸F]fluorodeoxyglucose positron emission tomography (FDG-PET): can postchemoradiotherapy FDG-PET predict the utility of resection? |journal=J. Clin. Oncol. |volume=28 |issue=31 |pages=4714–21 |year=2010 |pmid=20876421 |pmc=3020701 |doi=10.1200/JCO.2010.30.7702 |url=}}</ref<ref name="pmid23470576">{{cite journal |vauthors=Piessen G, Petyt G, Duhamel A, Mirabel X, Huglo D, Mariette C |title=Ineffectiveness of ¹⁸F-fluorodeoxyglucose positron emission tomography in the evaluation of tumor response after completion of neoadjuvant chemoradiation in esophageal cancer |journal=Ann. Surg. |volume=258 |issue=1 |pages=66–76 |year=2013 |pmid=23470576 |doi=10.1097/SLA.0b013e31828676c4 |url=}}</ref>><ref name="pmid27569732">{{cite journal |vauthors=Arnett AL, Merrell KW, Macintosh EM, James SE, Nathan MA, Shen KR, Ravi K, Neben Wittich MA, Haddock MG, Hallemeier CL |title=Utility of 18F-FDG PET for Predicting Histopathologic Response in Esophageal Carcinoma following Chemoradiation |journal=J Thorac Oncol |volume=12 |issue=1 |pages=121–128 |year=2017 |pmid=27569732 |doi=10.1016/j.jtho.2016.08.136 |url=}}</ref>


==Esophageal Ultrasound==
*Laparoscopic and thoracoscopic staging can be used to more accurately stage regional lymph nodes (particularly [[Celiac lymph nodes|celiac]] and intrathoracic) as compared to [[Endoscopic ultrasound|EUS]].<ref name="pmid17532386">{{cite journal |vauthors=Kaushik N, Khalid A, Brody D, Luketich J, McGrath K |title=Endoscopic ultrasound compared with laparoscopy for staging esophageal cancer |journal=Ann. Thorac. Surg. |volume=83 |issue=6 |pages=2000–2 |year=2007 |pmid=17532386 |doi=10.1016/j.athoracsur.2007.02.023 |url=}}</ref><ref name="pmid11308139">{{cite journal |vauthors=Krasna MJ, Reed CE, Nedzwiecki D, Hollis DR, Luketich JD, DeCamp MM, Mayer RJ, Sugarbaker DJ |title=CALGB 9380: a prospective trial of the feasibility of thoracoscopy/laparoscopy in staging esophageal cancer |journal=Ann. Thorac. Surg. |volume=71 |issue=4 |pages=1073–9 |year=2001 |pmid=11308139 |doi= |url=}}</ref>
EUS is the most accurate investigation for regional staging of esophageal cancer. It is capable of correctly staging T and N stagesin 90% of patients.<ref name="pmid24835402">{{cite journal |vauthors=Lee WC, Lee TH, Jang JY, Lee JS, Cho JY, Lee JS, Jeon SR, Kim HG, Kim JO, Cho YK |title=Staging accuracy of endoscopic ultrasound performed by nonexpert endosonographers in patients with resectable esophageal squamous cell carcinoma: is it possible? |journal=Dis. Esophagus |volume=28 |issue=6 |pages=574–8 |year=2015 |pmid=24835402 |doi=10.1111/dote.12235 |url=}}</ref>
*They can be used to determine intraperitoneal metstases in those patients with distal esophageal [[Adenocarcinoma|adenocarcinomas]].<ref name="pmid11373108">{{cite journal |vauthors=Bryan RT, Cruickshank NR, Needham SJ, Moffitt DD, Young JA, Hallissey MT, Fielding JW |title=Laparoscopic peritoneal lavage in staging gastric and oesophageal cancer |journal=Eur J Surg Oncol |volume=27 |issue=3 |pages=291–7 |year=2001 |pmid=11373108 |doi=10.1053/ejso.2001.1113 |url=}}</ref>  
*Furthermore, laparoscopy and thoracoscopy is used to limit aggressive treatment in those who have a locally advanced cancer.


[[Image:mass.jpg|thumb|center|500px|By Samir at the English language Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=3231456]]
===Bronchoscopy===
 
*Preoperative [[bronchoscopy]] with [[biopsy]] and [[Cytology|brush cytology]] has been implemented recently as the last phase in staging workup in those with a locally advanced tumor that is located at or above the [[Carina of trachea|carina]].<ref name="pmid9515844">{{cite journal |vauthors=Riedel M, Hauck RW, Stein HJ, Mounyam L, Schulz C, Schömig A, Siewert JR |title=Preoperative bronchoscopic assessment of airway invasion by esophageal cancer: a prospective study |journal=Chest |volume=113 |issue=3 |pages=687–95 |year=1998 |pmid=9515844 |doi= |url=}}</ref>




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Latest revision as of 16:38, 5 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

Laparoscopy, thoracoscopy and bronchoscopy can be used in addition to EUS and CT in locally advanced esophageal cancer to accurately diagnose and stage lymph node metastasis.

Other Diagnostic Studies

Laparoscopy and Thoracoscopy

  • Laparoscopic and thoracoscopic staging can be used to more accurately stage regional lymph nodes (particularly celiac and intrathoracic) as compared to EUS.[1][2]
  • They can be used to determine intraperitoneal metstases in those patients with distal esophageal adenocarcinomas.[3]
  • Furthermore, laparoscopy and thoracoscopy is used to limit aggressive treatment in those who have a locally advanced cancer.

Bronchoscopy


References

  1. Kaushik N, Khalid A, Brody D, Luketich J, McGrath K (2007). "Endoscopic ultrasound compared with laparoscopy for staging esophageal cancer". Ann. Thorac. Surg. 83 (6): 2000–2. doi:10.1016/j.athoracsur.2007.02.023. PMID 17532386.
  2. Krasna MJ, Reed CE, Nedzwiecki D, Hollis DR, Luketich JD, DeCamp MM, Mayer RJ, Sugarbaker DJ (2001). "CALGB 9380: a prospective trial of the feasibility of thoracoscopy/laparoscopy in staging esophageal cancer". Ann. Thorac. Surg. 71 (4): 1073–9. PMID 11308139.
  3. Bryan RT, Cruickshank NR, Needham SJ, Moffitt DD, Young JA, Hallissey MT, Fielding JW (2001). "Laparoscopic peritoneal lavage in staging gastric and oesophageal cancer". Eur J Surg Oncol. 27 (3): 291–7. doi:10.1053/ejso.2001.1113. PMID 11373108.
  4. Riedel M, Hauck RW, Stein HJ, Mounyam L, Schulz C, Schömig A, Siewert JR (1998). "Preoperative bronchoscopic assessment of airway invasion by esophageal cancer: a prospective study". Chest. 113 (3): 687–95. PMID 9515844.


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