The impact of endoscopic ultrasonography with fine needle aspiration (EUS-FNA) on esophageal cancer staging

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dc.contributor.author Azar, R. R.
dc.contributor.author Peifer, K. J.
dc.contributor.author Edmundowicz, S. A.
dc.contributor.author Early, D. S.
dc.contributor.author Meyers, B. F.
dc.contributor.author Jonnalagadda, S.
dc.contributor.author Maple, J. T.
dc.date.accessioned 2016-10-07T13:38:09Z
dc.date.available 2016-10-07T13:38:09Z
dc.date.copyright 2008 en_US
dc.date.issued 2016-10-07
dc.identifier.issn 1442-2050 en_US
dc.identifier.uri http://hdl.handle.net/10725/4537
dc.description.abstract SUMMARY.  Accurate staging of esophageal cancer is critical to achieving optimal treatment outcomes. End-oscopic ultrasound with fine needle aspiration (EUS-FNA) has emerged as a valuable tool for locoregional staging. However, it is unclear how different physician specialties perceive the benefit of EUS-FNA for esophageal cancer staging, and thus utilize this modality in clinical practice. A survey regarding utilization of EUS-FNA in esophageal cancer was distributed to 211 thoracic surgeons and 251 EUS-capable gastroenterologists. Seventy-six thoracic surgeons (36%) and 78 gastroenterologists (31%) responded to the survey. Most surgeons (75%) use EUS to stage potentially resectable esophageal cancer 75% of the time. Surgeons using EUS less often are less likely to have access to high-quality EUS services than their peers. Fewer surgeons believe EUS is the most accurate test for T and N-staging (84% and 71%, respectively) as compared with gastroenterologists (97% and 96%, P < 0.01 for both). Most endosonographers (68%) decide whether to dilate a malignant esophageal stricture to complete the staging exam on a case-by-case basis. Surgeons disagree as to whether involvement of celiac lymph nodes should preclude esophagectomy in distal esophageal cancer. While most thoracic surgeons have embraced EUS-FNA as the most accurate locoregional staging modality in esophageal cancer, this attitude is not fully reflected in utilization patterns due to a lack of quality EUS services in some centers. Controversial areas that warrant further study include dilation of malignant strictures to facilitate EUS staging, and the implication of involved celiac lymph nodes on management. en_US
dc.language.iso en en_US
dc.title The impact of endoscopic ultrasonography with fine needle aspiration (EUS-FNA) on esophageal cancer staging en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle a survey of thoracic surgeons and gastroenterologists en_US
dc.author.school SOM en_US
dc.author.idnumber 200902767 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Diseases of the Esophagus en_US
dc.journal.volume 21 en_US
dc.journal.issue 6 en_US
dc.article.pages 480-487 en_US
dc.keywords Endosonography en_US
dc.keywords Sophageal neoplasms en_US
dc.keywords Neoplasm staging en_US
dc.identifier.doi http://dx.doi.org/10.1111/j.1442-2050.2007.00804.x en_US
dc.identifier.ctation Maple, J. T., Peifer, K. J., Edmundowicz, S. A., Early, D. S., Meyers, B. F., Jonnalagadda, S., & Azar, R. R. (2008). The impact of endoscopic ultrasonography with fine needle aspiration (EUS‐FNA) on esophageal cancer staging: a survey of thoracic surgeons and gastroenterologists. Diseases of the Esophagus, 21(6), 480-487. en_US
dc.author.email riad.azar@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url http://onlinelibrary.wiley.com/doi/10.1111/j.1442-2050.2007.00804.x/full en_US

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