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Korean J Thorac Cardiovasc Surg 2004; 37(12): 992-998

Published online December 5, 2004

Copyright © Journal of Chest Surgery.

The Utility of Chest CTinStagingof Esophageal Cancer

Bong-Suk Oh, M.D.*, Seong-Beom Hong, M.D.*, Won-Chae Jang, M.D.*, Yun-Hyeon Kim, M.D.**, Byung-Pyo Kim, M.D.*, Yong-Sun Choi, M.D.*

Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Department of Diagnostic Radiology, Chonnam National University Medical Schoo

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The decision of staging of esophageal cancer have great effect on the resectability of the lesion and estimation of the patient's prognosis. Today, CT is one of the most popular modality for staging of esophageal cancer. However, it has some limitations because of false-positive or false-negative findings on cancer staging. The purpose of this study was to analyze the efficacy of CT in preoperative staging of esophageal cancer. Material and Method: We retrospectively analysed the difference of staging of esophageal cancer between CT and histopathological findings for the 114 patients with histologically proven esophageal cancer who underwent operation at the department of thoracic and cardiovascular surgery, Chonnam national university hospital, between January 1999 and June 2003. We evaluated the efficacy of chest CT in the staging of esophageal cancer compared to postoperative histopathologic findings by calculating sensitivity, specificity, accuracy, and reproducibility of chest CT to detect abnormality. Result: The reproducibilities between chest CT and histopathologic findings were 0.32 (p<0.01) for primary tumor (T), 0.36 (p<0.01) for lymph node invasion (N), and 0.62 (p<0.01) for distant metastasis (M). The reproducibilities between chest CT and histopathologic findings for lymph node invasion (N) and distant metastasis (M) were superior to that of primary tumor (T). The accuracy of primary tumor (T) was 65.8% and 98.2% in group III and IV, which was significantly higher than that of group I and II (78.9% and 62.3%). In general, specificity of chest CT for TNM staging was superior to sensitivity. Conclusion: In conclusion, preoperative CT scanning can provide important information on lymph node invasion and metastasis of lesion than primary tumor invasion. (Korean J Thorac Cardiovasc Surg 2004;37:992-998)

Keywords: 1. Esophageal neoplasm, 2. Computed tomography, 3. Neoplasm staging

Article

Original Article

Korean J Thorac Cardiovasc Surg 2004; 37(12): 992-998

Published online December 5, 2004

Copyright © Journal of Chest Surgery.

The Utility of Chest CTinStagingof Esophageal Cancer

Bong-Suk Oh, M.D.*, Seong-Beom Hong, M.D.*, Won-Chae Jang, M.D.*, Yun-Hyeon Kim, M.D.**, Byung-Pyo Kim, M.D.*, Yong-Sun Choi, M.D.*

Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Department of Diagnostic Radiology, Chonnam National University Medical Schoo

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The decision of staging of esophageal cancer have great effect on the resectability of the lesion and estimation of the patient's prognosis. Today, CT is one of the most popular modality for staging of esophageal cancer. However, it has some limitations because of false-positive or false-negative findings on cancer staging. The purpose of this study was to analyze the efficacy of CT in preoperative staging of esophageal cancer. Material and Method: We retrospectively analysed the difference of staging of esophageal cancer between CT and histopathological findings for the 114 patients with histologically proven esophageal cancer who underwent operation at the department of thoracic and cardiovascular surgery, Chonnam national university hospital, between January 1999 and June 2003. We evaluated the efficacy of chest CT in the staging of esophageal cancer compared to postoperative histopathologic findings by calculating sensitivity, specificity, accuracy, and reproducibility of chest CT to detect abnormality. Result: The reproducibilities between chest CT and histopathologic findings were 0.32 (p<0.01) for primary tumor (T), 0.36 (p<0.01) for lymph node invasion (N), and 0.62 (p<0.01) for distant metastasis (M). The reproducibilities between chest CT and histopathologic findings for lymph node invasion (N) and distant metastasis (M) were superior to that of primary tumor (T). The accuracy of primary tumor (T) was 65.8% and 98.2% in group III and IV, which was significantly higher than that of group I and II (78.9% and 62.3%). In general, specificity of chest CT for TNM staging was superior to sensitivity. Conclusion: In conclusion, preoperative CT scanning can provide important information on lymph node invasion and metastasis of lesion than primary tumor invasion. (Korean J Thorac Cardiovasc Surg 2004;37:992-998)

Keywords: 1. Esophageal neoplasm, 2. Computed tomography, 3. Neoplasm staging

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