Accuracy of contemporary oesophageal cancer lymph node staging with radiological-pathological correlation

• Published in: Clinical radiology 2017-08, Vol.72 (8), p.693.e1-693.e7
• Main Authors: Foley, K.G, Christian, A, Fielding, P, Lewis, W.G, Roberts, S.A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cohort Studies; Endosonography; Esophageal Neoplasms - diagnostic imaging; Esophageal Neoplasms - pathology; Female; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiology; Reproducibility of Results; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2017.02.022

Aim To evaluate the accuracy of contemporary N-staging and provide radiological–pathological correlation in patients with lymph node metastases (LNMs) that were radiologically staged N0. Materials and methods One hundred and twelve patients were included who underwent surgery alone ( n =41) or neoadjuvant therapy ( n =71) between October 2010 and December 2015. Contrast-enhanced computed tomography (CECT), endoscopic ultrasound (EUS), and combined positron-emission tomography (PET) and CT N-stage were compared to pathological N-stage [node-negative (N0) versus node-positive (N+) groups]. Fifty LNMs from 15 patients preoperatively staged as N0 were measured and the maximum size recorded. Results Accuracy, sensitivity, and specificity of N0 versus N+ disease with CECT, EUS, and PET/CT was 54.5%, 39.7% and 77.3%, 55.4%, 42.6% and 75%, and 57.1% 35.3%, and 90.9%, respectively. All techniques were more likely to under-stage nodal disease; CECT (X2 32.890, df=1, p