The role of endoscopic ultrasonography in assessing local resectability of oesophagogastric malignancies. Accuracy, pitfalls, and predictability.

Preoperative EUS was performed in 62 patients with oesophagogastric malignancy. The results were prospectively correlated with surgery and the histology of the resected specimens. Overall, a high degree of accuracy was obtained in EUS staging of the lesion and metastatic lymph node involvement. Clearly demarcated intramural hypoechoic structures with or without regional lymph node involvement indicated local resectability. Involvement of multiple distant lymph nodes predicted the palliative nature of the procedure. Deep infiltration of the tumour into the surrounding tissues and/or organs strongly suggested non-resectability. Differentiation between reactive and metastatic lymph node enlargement was occasionally difficult. Technical improvements enabling guided cytologic puncture may further enhance the diagnostic value of EUS.