Skip to Main Content

++

Endoscopic ultrasound (EUS) has a wide array of indications for diseases of the foregut. It can be used for staging, diagnosing, and even treating aspects of both benign and malignant processes of the esophagus, mediastinum, stomach, duodenum, pancreas, and additional extraintestinal organs. This chapter will focus on some of the most common indications for the use of EUS and particularly in ways in which management might be effected.

++

EUS in the Esophagus

++

Esophageal Cancer

++

The TNM classification (Table 11-1) is currently used for the staging of esophageal cancer1,2 and accurate staging is critical for directing patients to appropriate treatment protocols. For instance, 5-year survival is >95% for stage 0 disease, 50–80% for stage I disease, and 10–40% for stage II disease.1-3 EUS has been demonstrated to be most reliable for locoregional staging, staging T3 and T4 lesions with accuracies of 89–94% and 88–100%, respectively.4,5 T1 and T2 lesions can be differentiated from T3 and T4 lesions with an accuracy of 87%.6 EUS is the most accurate modality for staging of regional lymph nodes compared to CT scan and PET.7 The overall accuracy of N staging is 75–80% compared to CT (51–74%).5 FNA improves the diagnostic performance of EUS by at least 13%.8 Unfortunately, EUS’s role for metastases (M) staging has been disappointing. PET scan and CT remain the most accurate methods for M staging. Small liver metastasis may be better detected by EUS.9

++
Table Graphic Jump Location
Table 11-1 TNM Staging of Esophageal Cancer
++

Mediastinal Masses, Nodes, and Cysts

++

EUS is an excellent method of evaluating the posterior mediastinum. The role of EUS in the staging of lung cancer will ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.