Utility of dysphagia grade in predicting endoscopic ultrasound T ‐stage of non‐metastatic esophageal cancer

Summary Patients with non‐metastatic esophageal cancer routinely undergo endoscopic ultrasound (EUS) for loco‐regional staging. Neoadjuvant therapy is recommended for ≥T3 tumors while upfront surgery can be considered for ≤T2 lesions. The aim of this study was to determine if the degree of dysphagia can predict the EUS T‐stage of esophageal cancer. One hundred eleven consecutive patients with non‐metastatic esophageal cancer were retrospectively reviewed from a database. Prior to EUS, patients' dysphagia grade was recorded. Correlation between dysphagia grade and EUS T‐stage, especially in reference to predicting ≥T3 stage, was determined. The correlation of dysphagia grade with EUS T‐stage (Kendall's tau coefficient) was 0.49 (P < 0.001) for the lower and 0.59 (P = 0.008) for the middle esophagus. The sensitivity and specificity of dysphagia grade ≥2 (can only swallow semi‐solids/liquids) for T3 cancer were 56% (95% confidence interval [CI] 43–67%) and 93% (95% CI 79–98%), respectively. The sensitivity, specificity, and positive predictive value of dysphagia grade ≥3 (can only swallow liquids or total dysphagia) for T3 lesions were 36% (95% CI 25–48%), 100% (95% CI 89–100%), and 100% (95% CI 83–100%), respectively. Overall, there was a significant positive correlation between dysphagia grade and the EUS T‐stage of esophageal cancer. All patients with dysphagia grade ≥3 had T3 lesions. This may have clinical implications for patients w...
Source: Diseases of the Esophagus - Category: Gastroenterology Authors: Tags: Malignant Esophageal Disease Source Type: research