Schweizerische medizinische Wochenschrift · 1999
[Esophageal carcinoma: accurate staging thanks to modern diagnostic methods open up new therapeutic strategies].
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Schmassmann A
Аннотация
INTRODUCTION: Since the tumour stage has significant prognostic and therapeutic implications, accurate preoperative staging is decisive.
ALGORITHM FOR DIAGNOSTIC STUDIES: Flexible endoscopy of the oesophagus with biopsies is the first diagnostic step in patients with signs of oesophageal cancer and allows assessment of (1) tumour localisation, (2) tumour size, (3) grade of stricture, (4) type of histology, and (5) cellular grading. Thereafter, CT scan of the chest and upper abdomen is performed to assess the provisional TNM stage. The local TN stage is verified in operable patients by endosonography and additionally by bronchoscopy if the tumour is located in the upper half of the oesophagus. The M stage can be preoperatively verified by laparoscopy.
CONCLUSION: Modern diagnostic methods yield accurate staging, which makes it possible to optimise selection of the most appropriate therapeutic strategy.
ALGORITHM FOR DIAGNOSTIC STUDIES: Flexible endoscopy of the oesophagus with biopsies is the first diagnostic step in patients with signs of oesophageal cancer and allows assessment of (1) tumour localisation, (2) tumour size, (3) grade of stricture, (4) type of histology, and (5) cellular grading. Thereafter, CT scan of the chest and upper abdomen is performed to assess the provisional TNM stage. The local TN stage is verified in operable patients by endosonography and additionally by bronchoscopy if the tumour is located in the upper half of the oesophagus. The M stage can be preoperatively verified by laparoscopy.
CONCLUSION: Modern diagnostic methods yield accurate staging, which makes it possible to optimise selection of the most appropriate therapeutic strategy.