식도암 수술에서 식도내시경초음파(EUS) 진단의 효용성

초록

Background: With the advent of stage-adapted multimodal regiments for esophageal malignancy, accurate staging has become of utmost importance. Endoscopic ultrasonography(EUS) is a diagnostic method for the local staging of esophageal cancer, in particular for T and N evaluation. The aim of this study was to examine the diagnostic efficacy of the EUS and to evaluate the relation between prognosis and EUS findings. Material and Method:We reexamined the cases of 88 consecuitive patients who underwent transthroacic esophagectomy and cervical esophagogastrostomy for esophageal cancer from January 1991 to July 2001. We compared EUS findings, histological results and outcomes. Result：There were 83 male(94.3%) and 5 female. Median age was 61.3 years old. Overall staging accuracy were 59.0% for T staging and 76.0% for N staging, In early T staging group, the accuracy was 74.9% except T4 stage. However significant differences were not found in the ability of EUS-determined T-stage and N-stage to predict survival. Multivariate analysis showed EUS-stage to predict survival. Conclusion：EUS provides a high degree of accuracy in assessing both T and N parameters in staging esophagal cancer. EUS should be performed in all patients with esophageal cancer, not only for staging before therapy, but also as a valuable method of determining prognosis. (Korean J Thorac Cardiovasc Surg 2003;36:91-7)

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