Hancock Shawn M, Gopal Deepak V, Frick Terrence J, Pfau Patrick R
Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 4241 MFCB, 1685 Highland Avenue, Madison, WI 53705, USA.
Diagn Ther Endosc. 2011;2011:356538. doi: 10.1155/2011/356538. Epub 2011 Nov 30.
Background. Dilation of malignant strictures in endoscopic ultrasound (EUS) staging of esophageal cancer is safe, but no data exists regarding the subsequent development of metastases. Aim. Compare the rates of metastases in esophageal cancer patients undergoing EUS staging who require esophageal dilation in order to pass the echoendoscope versus those who do not. Methods. We reviewed consecutive patients referred for EUS staging of esophageal cancer. We evaluated whether dilation was necessary in order to pass the echoendoscope, and for the subsequent development of metastases after EUS at various time intervals. Results. Among all patients with similar stage (locally advanced disease, defined as T3, N0, M0 or T1-3, N1, M0), there was no difference between the dilated and nondilated groups in the rates of metastases at 3 months (14% versus 10%), P = 1.0, 6 months (28% versus 20%), P = 0.69, 12 months (43% versus 40%), P = 1.0, or ever during a mean followup of 15 months (71% versus 55%), P = 0.48. Conclusions. Dilation of malignant strictures for EUS staging of esophageal cancer does not appear to lead to higher rates of distant metastases.
背景。在食管癌内镜超声（EUS）分期中，对恶性狭窄进行扩张是安全的，但尚无关于后续转移发生情况的数据。目的。比较在EUS分期时需要进行食管扩张以便插入超声内镜的食管癌患者与不需要扩张的患者的转移率。方法。我们回顾了连续接受食管癌EUS分期检查的患者。我们评估了为插入超声内镜是否有必要进行扩张，以及在EUS检查后的不同时间间隔内转移的后续发生情况。结果。在所有处于相似分期（局部进展期疾病，定义为T3、N0、M0或T1 - 3、N1、M0）的患者中，扩张组和未扩张组在3个月时的转移率（14%对10%），P = 1.0；6个月时（28%对20%），P = 0.69；12个月时（43%对40%），P = 1.0；或在平均15个月的随访期间（71%对55%），P = 0.48，均无差异。结论。在食管癌EUS分期中对恶性狭窄进行扩张似乎不会导致远处转移率升高。
