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Last Updated: 2001-08-06 13:12:50 EDT (Reuters Health)
By David Douglas
WESTPORT, CT (Reuters Health) – Endoscopic ultrasonography (EUS) is useful in predicting long-term survival in certain patients with esophageal cancer, according to researchers at the Medical University of South Carolina in Charleston.
Dr. Mohamad A. Eloubeidi, now with the University of Alabama at Birmingham School of Medicine, and colleagues note that esophageal cancer patients with M1a disease reportedly "have poor survival." This appears to be particularly true of those with celiac lymph node metastases (CLN).
To determine whether EUS before surgical treatment might be useful in determining outcome, the researchers used the technique alone and in combination with fine-needle aspiration biopsy (FNA) to stage 211 patients with esophageal cancer. Of these, 182 had assessable celiac axes.
At least one CLN was imaged in 40% of these patients, the investigators report in the July issue of the Annals of Thoracic Surgery. The 5-year survival in this group was 13% versus 30% for patients with no detected CLNs. In addition, of 68 patients who underwent surgery, those who had no CLN involvement at the time of the procedure had a median survival of 39.8 months versus 13.8 months for those who did have malignant involvement.
In light of these findings, Dr. Eloubeidi told Reuters Health that "the survival of patients with celiac adenopathy is worse [than] that of patients without celiac adenopathy." Furthermore, he allowed that it was "possible, with the use of EUS and EUS-FNA, to determine the status of the celiac lymph node before chemotherapy and radiation."
"More importantly," Dr. Eloubeidi added, "we can assess the status of these lymph nodes after chemotherapy and radiation and determine whether the cancerous cells have been eradicated." Patients with "persistent disease in their lymph nodes might not benefit from surgery" and can be treated with further cycles of chemotherapy.
Ann Thorac Surg 2001;72:212-220.
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