WESTPORT, CT (Reuters Health) – Ultrasound is useful in determining the number of lymph node metastases in patients with esophageal cancer, and thereby predicting patient survival, Japanese researchers report.
As reported in the November issue of the Annals of Surgery, Dr. Shoji Natsugoe and colleagues from the Kagoshima University School of Medicine assessed the outcomes of 329 patients with esophageal cancer who underwent esophagectomy with lymphadenectomy. Prior to surgery, standard and endoscopic ultrasonography were performed to characterize lymph node involvement.
For each category of TNM classification, the diagnostic accuracy of both types of ultrasound exceeded 70%, the authors note. The metastatic lymph node rate based on ultrasound and histologic diagnosis was 69% and 59.3%, respectively, and the ultrasound diagnosis correlated significantly with the histologic diagnosis (p < 0.0001).
Ultrasound was 83.8%, 59.7%, 43.3%, and 96.0% accurate in detecting metastatic involvement of zero, one to three, four to seven, and eight or more lymph nodes, respectively. Five-year survival rates ranged from 53.3% for patients with no nodal involvement to 0% for patients with eight or more metastatic nodes, based on ultrasound assessment.
By determining the number of lymph node metastases, standard and endoscopic ultrasound are useful in predicting the prognosis of patients with esophageal cancer, Dr. Natsugoe and colleagues conclude. They believe that, in the future, the preoperative number of lymph node metastases may be incorporated into the current staging system for esophageal carcinoma.
Ann Surg 2001;234:613-618.
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