Role of endoscopic ultrasonography in the staging of esophageal cancer: a review

PURPOSE OF REVIEW: This review summarizes the important studies, published since April 2002, on the role of endoscopic ultrasonography for staging of esophageal cancer. RECENT FINDINGS: The loco-regional staging accuracy for esophageal cancer by endoscopic ultrasonography is superior to other currently available imaging modalities such as helical computed tomography. Endoscopic ultrasonographic staging accuracy is further enhanced by the ability to obtain guided fine needle aspiration specimens for cytology from any suspicious celiac lymph nodes. In addition to the initial staging of esophageal cancer, endoscopic ultrasonography-based measurement of reduction of tumor cross-sectional area appears to be a reliable predictor of pathologic response to initial neoadjuvant therapy. Recently published studies on the outcomes of endoscopic ultrasonography support its utility in the staging of esophageal cancer, particularly in guiding different treatment options for different stages of loco-regional involvement. SUMMARY: Overall, endoscopic ultrasonography for staging of patients with esophageal cancer seems to be a cost-effective intervention.