Impact of EUS-FNA in the management of patients with oesophageal cancer

Morris, J.M., Suzuki, H., McKernan, M., Stephen, M., Stuart, R.C. and Stanley, A.J. (2009) Impact of EUS-FNA in the management of patients with oesophageal cancer. Scottish Medical Journal, 54(2), pp. 30-33. (doi: 10.1258/rsmsmj.54.2.30) (PMID:19530500)

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Abstract

Background and Aim: Endoscopic Ultrasound (EUS) has increased the staging accuracy of oesophageal cancer. The addition of EUS guided fine needle aspiration (EUS-FNA) appears superior to standard EUS for nodal staging. Our aim was to study the impact of EUS-FNA in the management of patients with oesophageal cancer. Methods: We studied patients undergoing EUS for this indication between May 2003 and May 2006. EUS was performed in patients who were candidates for radical therapy following CT scanning. If suspicious non-peritumoural nodes were seen on EUS, EUS-FNA was undertaken. Further staging was performed as appropriate and all cases were discussed at our multidisciplinary meeting. Results and decisions were prospectively recorded. Results: One hundred and ninety one patients underwent EUS for staging of oesophageal cancer during this period and 44 EUS-FNA were performed in 42 patients (mean age 62.2 years). Sixty two per cent of patients had adenocarcinoma and 48% sampled nodes were < 10mm diameter. Overall, 48% nodes were positive and two “suspicious” for malignancy. Following a positive EUS-FNA and MDM discussions, 15 patients had palliative and two neoadjuvant therapy. Eleven patients with a negative EUSFNA underwent radical therapy. Therefore, EUS-FNA appeared to alter management in 28 (67%) patients. Conclusion: EUS-FNA appears to help direct patients towards appropriate treatment strategies.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Stanley, Dr Adrian and Stuart, Mr Robert and Morris, Dr John
Authors: Morris, J.M., Suzuki, H., McKernan, M., Stephen, M., Stuart, R.C., and Stanley, A.J.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Scottish Medical Journal
Publisher:SAGE Publications
ISSN:0036-9330
ISSN (Online):2045-6441
Published Online:01 May 2009

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