Nodal staging: Number or site of nodes? How to improve accuracy? Is FNA always necessary? Junctional tumors - What's N and what's M?

Abstract

In summary, EUS and EUS FNA are the most accurate techniques for preoperative local-regional staging of esophageal carcinoma, once CF and/ or PET scan have excluded the presence of distant metastasis. An experienced endosonographer, familiar with the EUS technique, and the inclusion of lymph node location, number of nodes and EUS T stage as diagnostic criteria may help improve preoperative lymph node staging accuracy in esophageal cancer. EUS FNA helps improve diagnostic accuracy in esophageal cancer staging. However, in patients with a certain number of EUS lymph node criteria, EUS FNA may be avoided without affecting diagnostic accuracy. In tumors of the distal esophagus detection and biopsy of celiac lymph nodes may be successfully perdormed by EUS and FNA. © Georg Thieme Verlag KG Stuttgart.