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Efficacy of Endoscopic Ultrasonography for Determining Clinical T Category for Esophageal Squamous Cell Carcinoma: Data From 1434 Surgical Cases

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The efficacy of endoscopic ultrasonography (EUS) for determining T category is variable for esophageal squamous cell carcinoma (ESCC). We aimed to assess the efficacy of EUS in accurately identifying T category for ESCC based on the 8th AJCC Cancer Staging Manual.

Methods

A retrospective analysis was conducted using a prospectively collected ESCC database from January 2003 to December 2015, in which all patients underwent EUS examination followed by esophagectomy. The efficacy of EUS was evaluated by sensitivity, specificity, and accuracy compared with pathological T category as gold standard. Overall survival of different EUS-T (uT) categories was assessed.

Results

In total, 1434 patients were included, of whom 58.2% were correctly classified by EUS, with 17.9% being overstaged and 23.9% being understaged. The sensitivity and accuracy of EUS for Tis, T1a, T1b, T2, T3, and T4a categories were 15.8 and 98.8%, 16.3 and 95.7%, 33.1 and 89.3%, 56.8 and 65.0%, 65.8 and 70.0%, and 27.3 and 97.5%, respectively. The survival difference between uT1a and uT1b was not statistically significant (p = 0.90), nor was that between uT4a and uT4b (p = 0.34). However, when uT category was integrated as uTis, uT1, uT2, uT3, and uT4, overall survival was clearly distinguished between the categories (p < 0.01).

Conclusions

EUS is in general feasible for classifying clinical T category for ESCC. However, EUS should be used with caution for discriminating between Tis, T1a, and T1b disease, as well as T4 disease.

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Acknowledgments

This work was supported by the Guangdong Esophageal Cancer Institute Science and Planning Foundation (M201401), National Natural Science Foundation of China (81501986), Guangdong Provincial Natural Science Foundation (2016A030313857), Guangdong Provincial Medical Scientific Funds (2016114134515565), and Guangdong Provincial Science and Technology Planning Foundation (2013B021800147).

Disclosure

The authors have no conflicts of interest to disclose.

Author information

Author notes

  1. Jie Yang and Guang-Yu Luo have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China

    Jie Yang MD, Run-Bin Liang MD, Hao Long MD, Jian-Hua Fu MD, Mu-Zi Yang MD, Shuo Li MD, Lan-Jun Zhang MD, Peng Lin MD, Xin Wang MD & Hao-Xian Yang MD

  2. State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China

    Jie Yang MD, Guang-Yu Luo MD, Run-Bin Liang MD, Hao Long MD, Jian-Hua Fu MD, Guo-Liang Xu MD, Mu-Zi Yang MD, Shuo Li MD, Lan-Jun Zhang MD, Peng Lin MD, Xin Wang MD, Xue Hou MD & Hao-Xian Yang MD

  3. Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China

    Jie Yang MD, Guang-Yu Luo MD, Run-Bin Liang MD, Hao Long MD, Jian-Hua Fu MD, Guo-Liang Xu MD, Mu-Zi Yang MD, Shuo Li MD, Lan-Jun Zhang MD, Peng Lin MD, Xin Wang MD, Xue Hou MD & Hao-Xian Yang MD

  4. Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China

    Guang-Yu Luo MD & Guo-Liang Xu MD

  5. School of Mathematical Sciences, South China Normal University, Guangzhou, Guangdong, China

    Tai-Shan Zeng PhD

  6. Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China

    Xue Hou MD

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  1. Jie Yang MD
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  2. Guang-Yu Luo MD
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  3. Run-Bin Liang MD
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  12. Xin Wang MD
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Corresponding authors

Correspondence to Xue Hou MD or Hao-Xian Yang MD.

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Yang, J., Luo, GY., Liang, RB. et al. Efficacy of Endoscopic Ultrasonography for Determining Clinical T Category for Esophageal Squamous Cell Carcinoma: Data From 1434 Surgical Cases. Ann Surg Oncol 25, 2075–2082 (2018). https://doi.org/10.1245/s10434-018-6406-9

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  • DOI: https://doi.org/10.1245/s10434-018-6406-9

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